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Safety, Tolerability, and Efficacy of XT-150 for the Treatment of Osteoarthritic Pain

Primary Purpose

Osteoarthritis, Knee

Status
Completed
Phase
Phase 1
Locations
United States
Study Type
Interventional
Intervention
XT-150
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, Cytokines, Interleukin-10, Gene therapy

Eligibility Criteria

18 Years - 90 Years (Adult, Older Adult)All SexesDoes not accept healthy volunteers

Inclusion Criteria:

  1. Male or female, between 18 and 90 years of age, inclusive
  2. Sufficiently severe OA of the knee to meet accepted criteria for knee arthroplasty
  3. Free of intra-articular infection, or infection at the injection site.
  4. Symptomatic disease because of osteoarthritis, defined as one or more of the following Visual Analog Scale of Pain Intensity (VASPI) scores:

    1. a worst pain of at least 70 at any time during the preceding week (based on scale of 0 to 100, with 100 representing "pain as bad as you can imagine").
    2. a worst stiffness of at least 70 at any time during the preceding week (based on a scale of 0 to 100, with 100 representing "stiffness as bad as you can imagine").
  5. Stable analgesic regimen during the 4 weeks prior to enrollment.
  6. Inadequate pain relief (minimum ≥5 mean on the Brief Pain Inventory-Severity Scale) lasting ≥3 months.
  7. In the judgment of the Investigator, acceptable general medical condition
  8. Life expectancy >6 months
  9. Female subjects of child-bearing potential, and those <1 year post-menopausal, must be practicing effective methods of birth control such as hormonal methods (e.g., combined oral, implantable, injectable, or transdermal contraceptives), double barrier methods (e.g., condoms, sponge, diaphragm) or total abstinence from heterosexual intercourse for a minimum of 1 month before study drug administration and agree to continue prevention methods for 3 months after participation in the study is completed.
  10. Male subjects who are heterosexually active and not surgically sterile must agree to use effective contraception, including abstinence, for the duration of the study and for 3 months after the study is completed.
  11. Have suitable knee joint anatomy for intra-articular injection
  12. Willing and able to return for the follow-up (FU) visits
  13. Able to reliably provide pain assessment
  14. Able to read and understand study instructions, and willing and able to comply with all study procedures

Exclusion Criteria:

  1. 1. Hypersensitivity, allergy, or significant reaction to any ingredient of the study drug, including double-stranded DNA, mannose, and sucrose
  2. Subject plans knee arthroplasty within 4 months, irrespective of the outcome of the trial or other conservative therapies
  3. High peri-procedural risks which in the judgment of the investigator preclude a safe knee injection procedure (e.g., poorly controlled diabetes, cardiac inadequacy such as NYHA class > II, G4 glomerular filtration rate [eGFR < 30 mL/min by Cockcroft-Gault])
  4. Current treatment with immunosuppressives (steroid therapy equivalent to >10mg/day prednisone); or other strong immunosuppressant
  5. History of systemic immunosuppressive therapy; steroids (equivalent to >10mg/day prednisone) in the last 3 months
  6. Currently receiving systemic chemotherapy or radiation therapy for malignancy
  7. 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, lactate dehydrogenase)
  8. Severe anemia (Grade 3; hemoglobin <8.0 g/dL, <4.9 mmol/L, <80 g/L; transfusion indicated), uncontrolled coagulopathy (Grade 1, prolonged activated partial prothrombin time (aPTT) > upper limit of normal (ULN) to 1.5xULN), or bleeding diathesis, Grade 1 white cell counts (lymphocytes <LLN - 800/mm3; <LLN - 0.8 x 10e9 /L, neutrophils <LLN - 1500/mm3; <LLN - 1.5 x 10e9 /L)
  9. Positive serology for human immunodeficiency virus, hepatitis B virus, or hepatitis C virus within 4 weeks of commencing the study
  10. Significant neuropsychiatric conditions; dementia, major depression, or altered mental state that in the opinion of the Investigator will interfere with study participation
  11. Current treatment with systemic antibiotics or antivirals (EXCEPTION: topical treatments)
  12. Current treatment with anticoagulants, other than low-dose aspirin, prescribed for new onset of symptoms in 3 months before screening visit.
  13. Known or suspected history of active alcohol or intravenous/oral drug abuse within 1 year before the screening visit
  14. Women who are pregnant or nursing
  15. Use of any investigational drug or device within 1 month 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.
  16. Any condition that, in the opinion of the Principal Investigator, could compromise the safety of the subject, the subject's ability to communicate with the study staff, or the quality of the data

Sites / Locations

  • Neurovations (Napa Pain Institute)

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm 4

Arm Type

Experimental

Experimental

Experimental

Experimental

Arm Label

Lowest dose

Second dose

Third dose

Highest dose

Arm Description

The lowest dose of XT-150 in the escalation schedule

The 2nd dose of XT-150 in the escalation sequence

The 3rd dose of XT-150 in the escalation sequence

The highest dose of XT-150 in the escalation sequence

Outcomes

Primary Outcome Measures

Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Clinical, laboratory measures of safety by CTCAE v4.0

Secondary Outcome Measures

Visual Analog Scale of Pain Intensity
Validated index of pain
Knee Injury and Osteoarthritis Outcomes Scale
KOOS
WOMAC
Western Ontario and McMasters University Osteoarthritis Index
Brief Pain Inventory
Measure of pain associated with osteoarthritis

Full Information

First Posted
March 13, 2018
Last Updated
November 6, 2019
Sponsor
Xalud Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT03477487
Brief Title
Safety, Tolerability, and Efficacy of XT-150 for the Treatment of Osteoarthritic Pain
Official Title
Preliminary Evaluation of Safety, Tolerability, and Efficacy of XT-150 for the Treatment of Osteoarthritic Pain
Study Type
Interventional

2. Study Status

Record Verification Date
October 2019
Overall Recruitment Status
Completed
Study Start Date
June 8, 2018 (Actual)
Primary Completion Date
July 19, 2019 (Actual)
Study Completion Date
September 30, 2019 (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
Evaluation of Safety, Tolerability, and Efficacy of XT-150, a plasmid DNA with a variant of human IL-10 transgene. XT-150 will be a single injection into the knee synovial capsule for the Treatment of Osteoarthritic Pain.
Detailed Description
Phase 1 dose escalation study to evaluate the safety, tolerability, and efficacy of a plasmid DNA encoding a variant of human IL-10. This 6-month study will follow subjects with severe osteoarthritis of the knee. Safety labs, physical exams, and blood levels of the IL-10 variant will be assessed for tolerability and any adverse events associated with the treatment.

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis, Knee
Keywords
inflammation, Cytokines, Interleukin-10, Gene therapy

7. Study Design

Primary Purpose
Treatment
Study Phase
Phase 1
Interventional Study Model
Sequential Assignment
Model Description
Ascending dose-ranging study
Masking
None (Open Label)
Allocation
Non-Randomized
Enrollment
32 (Actual)

8. Arms, Groups, and Interventions

Arm Title
Lowest dose
Arm Type
Experimental
Arm Description
The lowest dose of XT-150 in the escalation schedule
Arm Title
Second dose
Arm Type
Experimental
Arm Description
The 2nd dose of XT-150 in the escalation sequence
Arm Title
Third dose
Arm Type
Experimental
Arm Description
The 3rd dose of XT-150 in the escalation sequence
Arm Title
Highest dose
Arm Type
Experimental
Arm Description
The highest dose of XT-150 in the escalation sequence
Intervention Type
Biological
Intervention Name(s)
XT-150
Intervention Description
Human IL-10 variant transgene in a plasmid DNA vector
Primary Outcome Measure Information:
Title
Number of participants with treatment-related adverse events as assessed by CTCAE v4.0
Description
Clinical, laboratory measures of safety by CTCAE v4.0
Time Frame
6 months
Secondary Outcome Measure Information:
Title
Visual Analog Scale of Pain Intensity
Description
Validated index of pain
Time Frame
6 months
Title
Knee Injury and Osteoarthritis Outcomes Scale
Description
KOOS
Time Frame
6 months
Title
WOMAC
Description
Western Ontario and McMasters University Osteoarthritis Index
Time Frame
6 Months
Title
Brief Pain Inventory
Description
Measure of pain associated with osteoarthritis
Time Frame
6 months

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Maximum Age & Unit of Time
90 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: Male or female, between 18 and 90 years of age, inclusive Sufficiently severe OA of the knee to meet accepted criteria for knee arthroplasty Free of intra-articular infection, or infection at the injection site. Symptomatic disease because of osteoarthritis, defined as one or more of the following Visual Analog Scale of Pain Intensity (VASPI) scores: a worst pain of at least 70 at any time during the preceding week (based on scale of 0 to 100, with 100 representing "pain as bad as you can imagine"). a worst stiffness of at least 70 at any time during the preceding week (based on a scale of 0 to 100, with 100 representing "stiffness as bad as you can imagine"). Stable analgesic regimen during the 4 weeks prior to enrollment. Inadequate pain relief (minimum ≥5 mean on the Brief Pain Inventory-Severity Scale) lasting ≥3 months. In the judgment of the Investigator, acceptable general medical condition Life expectancy >6 months Female subjects of child-bearing potential, and those <1 year post-menopausal, must be practicing effective methods of birth control such as hormonal methods (e.g., combined oral, implantable, injectable, or transdermal contraceptives), double barrier methods (e.g., condoms, sponge, diaphragm) or total abstinence from heterosexual intercourse for a minimum of 1 month before study drug administration and agree to continue prevention methods for 3 months after participation in the study is completed. Male subjects who are heterosexually active and not surgically sterile must agree to use effective contraception, including abstinence, for the duration of the study and for 3 months after the study is completed. Have suitable knee joint anatomy for intra-articular injection Willing and able to return for the follow-up (FU) visits Able to reliably provide pain assessment 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 Subject plans knee arthroplasty within 4 months, irrespective of the outcome of the trial or other conservative therapies High peri-procedural risks which in the judgment of the investigator preclude a safe knee injection procedure (e.g., poorly controlled diabetes, cardiac inadequacy such as NYHA class > II, G4 glomerular filtration rate [eGFR < 30 mL/min by Cockcroft-Gault]) Current treatment with immunosuppressives (steroid therapy equivalent to >10mg/day prednisone); or other strong immunosuppressant History of systemic immunosuppressive therapy; steroids (equivalent to >10mg/day prednisone) in the last 3 months 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, lactate dehydrogenase) Severe anemia (Grade 3; hemoglobin <8.0 g/dL, <4.9 mmol/L, <80 g/L; transfusion indicated), uncontrolled coagulopathy (Grade 1, prolonged activated partial prothrombin time (aPTT) > upper limit of normal (ULN) to 1.5xULN), or bleeding diathesis, Grade 1 white cell counts (lymphocytes <LLN - 800/mm3; <LLN - 0.8 x 10e9 /L, neutrophils <LLN - 1500/mm3; <LLN - 1.5 x 10e9 /L) Positive serology for human immunodeficiency virus, hepatitis B virus, or hepatitis C virus within 4 weeks of commencing the study 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 treatment with anticoagulants, other than low-dose aspirin, prescribed for new onset of symptoms in 3 months before screening visit. Known or suspected history of active alcohol or intravenous/oral drug abuse within 1 year before the screening visit Women who are pregnant or nursing Use of any investigational drug or device within 1 month 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 Principal Investigator, could compromise the safety of the subject, the subject's ability to communicate with the study staff, or the quality of the data
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Stephen Collins, MD, PhD
Organizational Affiliation
Xalud Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Neurovations (Napa Pain Institute)
City
Napa
State/Province
California
ZIP/Postal Code
94558
Country
United States

12. IPD Sharing Statement

Plan to Share IPD
No

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Safety, Tolerability, and Efficacy of XT-150 for the Treatment of Osteoarthritic Pain

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