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Study to Evaluate Intra-articular Resiniferatoxin to Treat Moderate to Severe Pain From Knee Osteoarthritis

Primary Purpose

Osteoarthritis, Knee, Knee Osteoarthritis, Knee Pain Chronic

Status
Active
Phase
Phase 2
Locations
United States
Study Type
Interventional
Intervention
Resiniferatoxin
Zilretta
Placebo
Sponsored by
Sorrento Therapeutics, Inc.
About
Eligibility
Locations
Arms
Outcomes
Full info

About this trial

This is an interventional treatment trial for Osteoarthritis, Knee focused on measuring osteoarthritis, knee pain, knee

Eligibility Criteria

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

Inclusion Criteria:

  • BMI < 50 kg/m
  • Have moderate-to-severe pain in the index knee due to osteoarthritis (OA) as assessed by the investigator, based on American College of Rheumatology criteria
  • Have had OA pain duration in the index knee ≥ 6 months prior to Screening
  • Reports worst daily average pain with walking of ≥ 4 on the 0 to 10 NRS for pain intensity during the week prior to Screening
  • Have a knee x-ray or MRI scan with KL grade ≥ 2 in the index knee based upon radiographic images obtained within 3 months prior to Screening (image must be available for review)
  • Have had treatment failure with at least two prior analgesic agents (at least one NSAID) defined as discontinuation due to side effects or inadequate response to treatment
  • Willing to abstain from other IA injections or knee surgery for at least 6 months after study treatment unless elects early discontinuation from the study
  • Able to comply with the study procedures and give informed consent
  • If on any analgesic medications, have been taking a stable dose for at least one month prior to screening with no increase in dose leading up to study treatment. Note that if the subject is on "as needed" or PRN analgesic medications, these may be continued during the study
  • Willing to follow contraception guidelines

Exclusion Criteria:

  • Have a history of a hemorrhagic event that is CTCAEv5 Grade 2 or higher within the 6 months prior to screening
  • Have evidence of or history of a serious coagulopathy or hemostasis problem at Screening or Baseline
  • Have had an IA injection in the index knee within one month prior to screening (3 months if prior IA injection with Zilretta)
  • Have undergone arthroscopic or open surgery or replacement surgery to the index knee within 6 months of screening
  • Have surgical hardware or other foreign bodies within the index knee joint
  • Have current instability/misalignment in the index knee post repair
  • Have a sensory peripheral neuropathy that is CTCAEv5 Grade 2 or higher involving the index leg at Screening
  • Have significant pain in other joints or body locations that make it difficult to assess pain in the index knee
  • If on opioid analgesics to treat knee OA, have an upper limit of 30 mg/day as converted to an oral morphine equivalent dose
  • Have a history of substance abuse
  • Have an allergy or hypersensitivity to capsaicin, chili peppers, lidocaine or resiniferatoxin
  • Pregnant at Screening or planning on becoming pregnant or currently breastfeeding
  • Have had a non-study related minor surgical procedure ≤ 3 days or major surgical procedure ≤ 14 days prior to Screening and must be sufficiently recovered and stable prior to study treatment
  • Have any medical condition or medical comorbidities that, in the Investigator's opinion, could adversely impact study participation or safety, conduct of the study, or interfere with pain assessments

Sites / Locations

  • Horizon Clinical Research
  • Lotus Clinical Research
  • Affinity Health
  • Advance Pain
  • HD Research LLC
  • HD Research LLC

Arms of the Study

Arm 1

Arm 2

Arm 3

Arm Type

Experimental

Active Comparator

Placebo Comparator

Arm Label

Resiniferatoxin

Zilretta

Placebo

Arm Description

7.5 mcg, 10 mcg, 12.5 mcg, 15 mcg, or 20 mcg in 5 mL injected once intra-articularly

32 mg in 5 mL injected once intra-articularly

5 mL injected once intra-articularly

Outcomes

Primary Outcome Measures

Change in Worst Average Daily Pain at Week 26
Change from baseline through Week 26 in the weekly mean of Worst Average Daily Pain in the previous 24 hours with walking (WADP) using the Numerical Rating Scale of pain intensity, 0-10 scale (NRS)

Secondary Outcome Measures

Duration of response
Time to return to within 10% of baseline pain score with walking based on the weekly mean WADP scores using the NRS (0-10)
Change in Worst Average Daily Pain at Week 12
Change from baseline through Week 12 in the weekly mean of Worst Average Daily Pain in the previous 24 hours with walking (WADP) using the Numerical Rating Scale of pain intensity, 0-10 scale (NRS).
Change in quality of life
Change from baseline to Week 26 in the Knee Injury and Osteoarthritis Outcome Score (KOOS) Quality of Life (QoL) subscale
Change in WOMAC score
Change from baseline to Week 12 in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score (WOMAC-TW12) and subscale scores

Full Information

First Posted
May 10, 2021
Last Updated
January 12, 2023
Sponsor
Sorrento Therapeutics, Inc.
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1. Study Identification

Unique Protocol Identification Number
NCT04885972
Brief Title
Study to Evaluate Intra-articular Resiniferatoxin to Treat Moderate to Severe Pain From Knee Osteoarthritis
Official Title
A Phase 2, Randomized, Active and Placebo-Controlled, Dose Ranging Study to Evaluate the Efficacy and Safety of Intra-articular Resiniferatoxin to Treat Moderate to Severe Pain From Knee Osteoarthritis
Study Type
Interventional

2. Study Status

Record Verification Date
January 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
November 15, 2021 (Actual)
Primary Completion Date
September 2023 (Anticipated)
Study Completion Date
November 2023 (Anticipated)

3. Sponsor/Collaborators

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

4. Oversight

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

5. Study Description

Brief Summary
This study evaluates the efficacy and safety of a single IA injection of various RTX doses, Zilretta or placebo for the treatment of pain due to moderate to severe osteoarthritis knee pain..
Detailed Description
This study is a multi-center, Phase 2, randomized, dose ranging, assessor-blinded, active and placebo-controlled, parallel-group prospective study evaluating the efficacy and safety of a single IA injection of various RTX doses, Zilretta or placebo for the treatment of pain due to moderate to severe osteoarthritis knee pain. A planned 112 subjects will be randomized to one of 7 groups (n=16 each) with each subject receiving one IA injection in the index knee joint (the knee primarily affected by pain if bilateral).

6. Conditions and Keywords

Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis, Knee, Knee Osteoarthritis, Knee Pain Chronic
Keywords
osteoarthritis, knee pain, knee

7. Study Design

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

8. Arms, Groups, and Interventions

Arm Title
Resiniferatoxin
Arm Type
Experimental
Arm Description
7.5 mcg, 10 mcg, 12.5 mcg, 15 mcg, or 20 mcg in 5 mL injected once intra-articularly
Arm Title
Zilretta
Arm Type
Active Comparator
Arm Description
32 mg in 5 mL injected once intra-articularly
Arm Title
Placebo
Arm Type
Placebo Comparator
Arm Description
5 mL injected once intra-articularly
Intervention Type
Drug
Intervention Name(s)
Resiniferatoxin
Other Intervention Name(s)
RTX
Intervention Description
Resiniferatoxin is a compound purified from natural sources.
Intervention Type
Drug
Intervention Name(s)
Zilretta
Other Intervention Name(s)
triamcinolone acetonide
Intervention Description
Zilretta is an extended-release corticosteroid approved to manage osteoarthritis knee pain.
Intervention Type
Drug
Intervention Name(s)
Placebo
Intervention Description
Vehicle solution
Primary Outcome Measure Information:
Title
Change in Worst Average Daily Pain at Week 26
Description
Change from baseline through Week 26 in the weekly mean of Worst Average Daily Pain in the previous 24 hours with walking (WADP) using the Numerical Rating Scale of pain intensity, 0-10 scale (NRS)
Time Frame
Baseline to Week 26
Secondary Outcome Measure Information:
Title
Duration of response
Description
Time to return to within 10% of baseline pain score with walking based on the weekly mean WADP scores using the NRS (0-10)
Time Frame
Baseline through end of study at Week 52
Title
Change in Worst Average Daily Pain at Week 12
Description
Change from baseline through Week 12 in the weekly mean of Worst Average Daily Pain in the previous 24 hours with walking (WADP) using the Numerical Rating Scale of pain intensity, 0-10 scale (NRS).
Time Frame
Baseline to Week 12
Title
Change in quality of life
Description
Change from baseline to Week 26 in the Knee Injury and Osteoarthritis Outcome Score (KOOS) Quality of Life (QoL) subscale
Time Frame
Baseline to Week 26
Title
Change in WOMAC score
Description
Change from baseline to Week 12 in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score (WOMAC-TW12) and subscale scores
Time Frame
Baseline to Week 12

10. Eligibility

Sex
All
Minimum Age & Unit of Time
18 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria: BMI < 50 kg/m Have moderate-to-severe pain in the index knee due to osteoarthritis (OA) as assessed by the investigator, based on American College of Rheumatology criteria Have had OA pain duration in the index knee ≥ 6 months prior to Screening Reports worst daily average pain with walking of ≥ 4 on the 0 to 10 NRS for pain intensity during the week prior to Screening Have a knee x-ray or MRI scan with KL grade ≥ 2 in the index knee based upon radiographic images obtained within 3 months prior to Screening (image must be available for review) Have had treatment failure with at least two prior analgesic agents (at least one NSAID) defined as discontinuation due to side effects or inadequate response to treatment Willing to abstain from other IA injections or knee surgery for at least 6 months after study treatment unless elects early discontinuation from the study Able to comply with the study procedures and give informed consent If on any analgesic medications, have been taking a stable dose for at least one month prior to screening with no increase in dose leading up to study treatment. Note that if the subject is on "as needed" or PRN analgesic medications, these may be continued during the study Willing to follow contraception guidelines Exclusion Criteria: Have a history of a hemorrhagic event that is CTCAEv5 Grade 2 or higher within the 6 months prior to screening Have evidence of or history of a serious coagulopathy or hemostasis problem at Screening or Baseline Have had an IA injection in the index knee within one month prior to screening (3 months if prior IA injection with Zilretta) Have undergone arthroscopic or open surgery or replacement surgery to the index knee within 6 months of screening Have surgical hardware or other foreign bodies within the index knee joint Have current instability/misalignment in the index knee post repair Have a sensory peripheral neuropathy that is CTCAEv5 Grade 2 or higher involving the index leg at Screening Have significant pain in other joints or body locations that make it difficult to assess pain in the index knee If on opioid analgesics to treat knee OA, have an upper limit of 30 mg/day as converted to an oral morphine equivalent dose Have a history of substance abuse Have an allergy or hypersensitivity to capsaicin, chili peppers, lidocaine or resiniferatoxin Pregnant at Screening or planning on becoming pregnant or currently breastfeeding Have had a non-study related minor surgical procedure ≤ 3 days or major surgical procedure ≤ 14 days prior to Screening and must be sufficiently recovered and stable prior to study treatment Have any medical condition or medical comorbidities that, in the Investigator's opinion, could adversely impact study participation or safety, conduct of the study, or interfere with pain assessments
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Mike Royal, MD
Organizational Affiliation
Sorrento Therapeutics, Inc.
Official's Role
Study Director
Facility Information:
Facility Name
Horizon Clinical Research
City
La Mesa
State/Province
California
ZIP/Postal Code
91942
Country
United States
Facility Name
Lotus Clinical Research
City
Pasadena
State/Province
California
ZIP/Postal Code
91105
Country
United States
Facility Name
Affinity Health
City
Oak Brook
State/Province
Illinois
ZIP/Postal Code
60523
Country
United States
Facility Name
Advance Pain
City
Edgewood
State/Province
Kentucky
ZIP/Postal Code
41017
Country
United States
Facility Name
HD Research LLC
City
Bellaire
State/Province
Texas
ZIP/Postal Code
77401
Country
United States
Facility Name
HD Research LLC
City
Carrollton
State/Province
Texas
ZIP/Postal Code
75006
Country
United States

12. IPD Sharing Statement

Learn more about this trial

Study to Evaluate Intra-articular Resiniferatoxin to Treat Moderate to Severe Pain From Knee Osteoarthritis

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