Study of Ampion for the Treatment of Pain and Function in Patients With Severe Osteoarthritis of the Knee.
Primary Purpose
Severe Osteoarthritis of the Knee
Status
Terminated
Phase
Phase 3
Locations
United States
Study Type
Interventional
Intervention
Ampion
Saline
Sponsored by
About this trial
This is an interventional treatment trial for Severe Osteoarthritis of the Knee focused on measuring Osteoarthritis, osteoarthritis of the knee
Eligibility Criteria
Inclusion Criteria:
- Able to provide written informed consent to participate in the study
- Willing and able to comply with all study requirements and instructions of the site study staff
- Must be ambulatory
- Index knee must be symptomatic for greater than 6 months with a clinical diagnosis of OAK and supported by radiological evidence (Kellgren-Lawrence Grade 4) that is not older than 6 months prior to the date of screening
- Moderate to moderately-severe osteoarthritis (OA) pain in the index knee (rating of at least 1.5 on the WOMAC Index 3.1 as measured by 5-point Likert Pain Subscale) assessed at screening
- Ability to temporarily discontinue nonsteroidal anti-inflammatory drug (NSAID) for 48 hours prior to scheduled clinical efficacy evaluations
- No analgesia (including acetaminophen [paracetamol]) taken 12 hours prior to an efficacy measure
- No known clinically significant liver abnormality (e.g. cirrhosis, transplant, etc.).
Exclusion Criteria:
- As a result of medical review and screening investigation, the Principal Investigator considers the patient unfit for the study
- A history of allergic reactions to human albumin (reaction to non-human albumin such as egg albumin is not an exclusion criterion)
- A history of allergic reactions to excipients in 5% human albumin (N-acetyltryptophan, sodium caprylate)
- Presence of tense effusions
- Inflammatory or crystal arthropathies, acute fractures, history of aseptic necrosis or joint replacement in the affected knee, as assessed locally by the Principal Investigator
- Isolated patella femoral syndrome, also known as chondromalacia
- Any other disease or condition interfering with the free use and evaluation of the index knee for the duration of the trial (e.g. cancer, congenital defects, spine osteoarthritis)
- Major injury to the index knee within the 12 months prior to screening
- Severe hip osteoarthritis ipsilateral to the index knee
- Any pain that could interfere with the assessment of index knee pain (e.g. pain in any other part of the lower extremities, pain radiating to the knee)
- Any pharmacological or non-pharmacological treatment targeting OA started or changed during the 4 weeks prior to randomization or likely to be changed during the duration of the study
Use of the following medications:
- No IA injected pain medications in the study knee during the study
- No analgesics containing opioids. NSAIDs may be continued at levels preceding the study, however may not be used 48 hours prior to efficacy evaluations, and acetaminophen is available as a rescue medication during the study from the provided supply
- No topical treatment on osteoarthritis index knee during the study
- No significant anticoagulant therapy (e.g. Heparin or Lovenox) during the study (treatment such as Aspirin and Plavix are allowed)
- No systemic treatments that may interfere with safety or efficacy assessments during the study
- No immunosuppressants
- No use of corticosteroids > 10 mg prednisolone equivalent per day
- If corticosteroid use is ≤ 10 mg prednisolone equivalent per day, and if clinically indicated, subjects should be allowed to decrease their corticosteroid use. Additionally, some subjects may need to increase their steroid dose to treat worsened symptoms in the treated knee, and subjects who increase their corticosteroid dose above their starting dose of corticosteroid during the study will be treated as "treatment failures" for efficacy analysis
- No human albumin treatment in the 3 months before randomization or throughout the duration of the study
Sites / Locations
- Denver Metro Orthopedics
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Placebo Comparator
Arm Label
AMPION™ 4 mL dose
Saline
Arm Description
4 mL injection of Ampion
4 mL injection of placebo
Outcomes
Primary Outcome Measures
Change in Knee Pain
Mean Change in WOMAC A Pain (Western Ontario and McMaster Universities Arthritis Index) score from Baseline to 12 weeks. 5-point Likert scale (0=none to 4=extreme). A negative difference constitutes a decrease in pain with a greater negative value indicating a greater reduction in pain.
Change in Knee Function
Mean change in WOMAC C function score (Western Ontario and McMaster Universities Arthritis Index) from Baseline to 12 weeks. 5-point Likert scale indicating limitation of function (0=none to 4=extreme). A greater negative value indicates a improvement in function.
Secondary Outcome Measures
Full Information
NCT ID
NCT03988023
First Posted
June 13, 2019
Last Updated
September 27, 2022
Sponsor
Ampio Pharmaceuticals. Inc.
1. Study Identification
Unique Protocol Identification Number
NCT03988023
Brief Title
Study of Ampion for the Treatment of Pain and Function in Patients With Severe Osteoarthritis of the Knee.
Official Title
A Randomized, Controlled, Double-Blind Study to Evaluate the Efficacy and Safety of an Intra-Articular Injection of Ampion in Adults With Pain Due to Severe Osteoarthritis of the Knee.
Study Type
Interventional
2. Study Status
Record Verification Date
August 2022
Overall Recruitment Status
Terminated
Why Stopped
The AP-013 study was prematurely terminated by the sponsor after Data Safety Monitoring Board (DSMB) guidance.
Study Start Date
June 24, 2019 (Actual)
Primary Completion Date
July 13, 2021 (Actual)
Study Completion Date
July 13, 2021 (Actual)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Ampio Pharmaceuticals. Inc.
4. Oversight
Studies a U.S. FDA-regulated Drug Product
Yes
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
Yes
5. Study Description
Brief Summary
The purpose of this study is to confirm the safety and efficacy of Ampion for the treatment of pain and function in patients with severe osteoarthritis of the knee.
Detailed Description
This study is a randomized, double-blind, single dose design.
The co-primary trial objectives are to evaluate the greater efficacy for pain improvement and function improvement of 4 mL Ampion versus saline intra-articular (IA) injection when applied to patients suffering from severe osteoarthritis of the knee (OAK). Efficacy will primarily be assessed with WOMAC A pain and WOMAC C function scores.
Mean change in the WOMAC A weekly pain scores from Baseline to Week 12 will be compared between Ampion and saline control. Mean change in WOMAC C function score will be compared between Ampion and saline control. This will test whether Ampion is superior to saline in improving pain and function.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Severe Osteoarthritis of the Knee
Keywords
Osteoarthritis, osteoarthritis of the knee
7. Study Design
Primary Purpose
Treatment
Study Phase
Phase 3
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Allocation
Randomized
Enrollment
1043 (Actual)
8. Arms, Groups, and Interventions
Arm Title
AMPION™ 4 mL dose
Arm Type
Experimental
Arm Description
4 mL injection of Ampion
Arm Title
Saline
Arm Type
Placebo Comparator
Arm Description
4 mL injection of placebo
Intervention Type
Biological
Intervention Name(s)
Ampion
Intervention Description
4 mL injection of Ampion
Intervention Type
Drug
Intervention Name(s)
Saline
Other Intervention Name(s)
0.9% Saline
Intervention Description
Saline solution, 4 mL, single intra-articular injection
Primary Outcome Measure Information:
Title
Change in Knee Pain
Description
Mean Change in WOMAC A Pain (Western Ontario and McMaster Universities Arthritis Index) score from Baseline to 12 weeks. 5-point Likert scale (0=none to 4=extreme). A negative difference constitutes a decrease in pain with a greater negative value indicating a greater reduction in pain.
Time Frame
Scored at Baseline and 12 Week
Title
Change in Knee Function
Description
Mean change in WOMAC C function score (Western Ontario and McMaster Universities Arthritis Index) from Baseline to 12 weeks. 5-point Likert scale indicating limitation of function (0=none to 4=extreme). A greater negative value indicates a improvement in function.
Time Frame
Scored at Baseline and 12 weeks.
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:
Able to provide written informed consent to participate in the study
Willing and able to comply with all study requirements and instructions of the site study staff
Must be ambulatory
Index knee must be symptomatic for greater than 6 months with a clinical diagnosis of OAK and supported by radiological evidence (Kellgren-Lawrence Grade 4) that is not older than 6 months prior to the date of screening
Moderate to moderately-severe osteoarthritis (OA) pain in the index knee (rating of at least 1.5 on the WOMAC Index 3.1 as measured by 5-point Likert Pain Subscale) assessed at screening
Ability to temporarily discontinue nonsteroidal anti-inflammatory drug (NSAID) for 48 hours prior to scheduled clinical efficacy evaluations
No analgesia (including acetaminophen [paracetamol]) taken 12 hours prior to an efficacy measure
No known clinically significant liver abnormality (e.g. cirrhosis, transplant, etc.).
Exclusion Criteria:
As a result of medical review and screening investigation, the Principal Investigator considers the patient unfit for the study
A history of allergic reactions to human albumin (reaction to non-human albumin such as egg albumin is not an exclusion criterion)
A history of allergic reactions to excipients in 5% human albumin (N-acetyltryptophan, sodium caprylate)
Presence of tense effusions
Inflammatory or crystal arthropathies, acute fractures, history of aseptic necrosis or joint replacement in the affected knee, as assessed locally by the Principal Investigator
Isolated patella femoral syndrome, also known as chondromalacia
Any other disease or condition interfering with the free use and evaluation of the index knee for the duration of the trial (e.g. cancer, congenital defects, spine osteoarthritis)
Major injury to the index knee within the 12 months prior to screening
Severe hip osteoarthritis ipsilateral to the index knee
Any pain that could interfere with the assessment of index knee pain (e.g. pain in any other part of the lower extremities, pain radiating to the knee)
Any pharmacological or non-pharmacological treatment targeting OA started or changed during the 4 weeks prior to randomization or likely to be changed during the duration of the study
Use of the following medications:
No IA injected pain medications in the study knee during the study
No analgesics containing opioids. NSAIDs may be continued at levels preceding the study, however may not be used 48 hours prior to efficacy evaluations, and acetaminophen is available as a rescue medication during the study from the provided supply
No topical treatment on osteoarthritis index knee during the study
No significant anticoagulant therapy (e.g. Heparin or Lovenox) during the study (treatment such as Aspirin and Plavix are allowed)
No systemic treatments that may interfere with safety or efficacy assessments during the study
No immunosuppressants
No use of corticosteroids > 10 mg prednisolone equivalent per day
If corticosteroid use is ≤ 10 mg prednisolone equivalent per day, and if clinically indicated, subjects should be allowed to decrease their corticosteroid use. Additionally, some subjects may need to increase their steroid dose to treat worsened symptoms in the treated knee, and subjects who increase their corticosteroid dose above their starting dose of corticosteroid during the study will be treated as "treatment failures" for efficacy analysis
No human albumin treatment in the 3 months before randomization or throughout the duration of the study
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Howard Levy, M.D.
Organizational Affiliation
Ampio Pharmaceuticals. Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Denver Metro Orthopedics
City
Englewood
State/Province
Colorado
ZIP/Postal Code
80113
Country
United States
12. IPD Sharing Statement
Plan to Share IPD
No
Learn more about this trial
Study of Ampion for the Treatment of Pain and Function in Patients With Severe Osteoarthritis of the Knee.
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