Treatment of Knee Osteoarthritis With PAAG-OA (ROSA)
Primary Purpose
Osteoarthritis, Knee
Status
Active
Phase
Not Applicable
Locations
Denmark
Study Type
Interventional
Intervention
PAAG-OA
Synvisc-One
Sponsored by
About this trial
This is an interventional treatment trial for Osteoarthritis, Knee
Eligibility Criteria
Inclusion Criteria:
- Signed and dated informed consent form
- Stated willingness to comply with all study procedures and availability for the duration of the study
- Male or female, aged ≥ 40 years
- Clinical diagnosis of knee OA American College of Rheumatology criteria confirmed by radiology
- Definite radiographic OA in the most symptomatic knee (target knee) at mild to moderate-stage (Kellgren-Lawrence grades 2 or 3)
- Stable dose of analgesics for the past four weeks
- NRS (11 points (0-10) pain intensity numerical rating scale) ≥ 4 in target knee, during the past week when walking
- Body Mass Index (BMI) between 20-35
- For females of reproductive potential: use of adequate contraception must be used throughout the trial
Exclusion Criteria:
- Female participants who are pregnant, lactating or planning pregnancy during the course of the clinical investigation
- Contraindications to PAAG-OA or Synvisc-One®, according to IB or Instruction for Use (IFU)
- Previous intra-articular injection of polyacrylamide gel in the target knee
- Previous intra-articular injection with hyaluronic acid or derivatives in target knee in the previous 6 months
- Significant valgus/varus deformity of the knee, ligamentous laxity or meniscal instability
- Other diseases in target knee than osteoarthritis
- Intra-articular injection of any substance other than hyaluronic acid (e.g. corticosteroids) in the target knee within the last 3 months
- Acute serious infection of any region that required hospital care or intravenous antibiotic treatment within the last 30 days, or oral antibiotic treatment within the last 14 days
- Skin disease or infections in the area of the injection site
- Infected or severely inflamed knees
- History of sepsis in any joint or any clinical concern for a subacute infectious process in the target knee
- History of surgery in the target knee within the past 6 months
- Symptomatic osteoarthritis of the hips, spine or ankle, that interferes with the evaluation of the target knee
- Planned surgery on any lower extremity
- Clinically significant venous or lymphatic stasis present in the legs
- Clinically apparent tense effusion or inflammation in the target knee
- Suffering from any unstable or severe cardio-vascular disease
- Any contraindication to intra-articular e.g. anticoagulant therapy or clinical concern for potential coagulopathy (e.g. liver disease)
- Any foreign material in the target joint
- Any significant medical condition (e.g. significant psychiatric or neurological disorders or active alcohol/drug abuse), any medical condition that is unstable/poorly controlled or other factors that may interfere with study participation
- Treatment with systemic steroids
- History of drug/alcohol abuse, mental dysfunction of other factors limiting their ability to cooperate fully
- Change in physiotherapy within the previous month
- Fibromyalgia
- Inflammatory or other disease/condition which may affect joints (e.g. rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis among others)
- Haemophilia
- Any other condition that in the opinion of the investigator put a potential participant at risk or otherwise precludes participation in the trial
- Known allergic reactions to components of Synvisc-One (avian protein)
- Known allergic reactions to antibiotics (azithromycin and moxifloxacin) or local anaesthesia
- Participation in any experimental device study within 6 months prior to enrolment, or participation in an experimental drug study within 1 month prior to enrolment
Sites / Locations
- The Parker Institute
- A2 Reumatologi og idrætsmedicin
- Reumatolog i Odense
Arms of the Study
Arm 1
Arm 2
Arm Type
Experimental
Active Comparator
Arm Label
PAAG-OA
Synvisc-One
Arm Description
Intra-articular injection with PAAG-OA (polyacrylamide hydrogel)
Intra-articular injection with Synvisc-One (hyaluronic acid)
Outcomes
Primary Outcome Measures
Comparing one injection of PAAG-OA with one injection of Synvisc-One on pain over 6 months in subjects with knee osteoarthritis
Change in WOMAC (WOMAC Osteoarthritis Index) pain subscale. Pain is reported in each of five response categories (0=none, 4=extreme)
Secondary Outcome Measures
WOMAC
WOMAC (WOMAC Osteoarthritis Index) self reported pain, stiffness and physical function, categories (0=none, 4=extreme)
PGA (Patient Global Assessment)
PGA reported on a 10 cm Visual Analogue Scale
EQ-5D-5L, QoL
EQ-5D-5L, Quality of Life, comprised of descriptive system where each dimension has 5 levels (ranging from no problems to extreme problems) and a 20 cm Visual Analogue Scale (0 = worst health and 100 = best health)
OMERACT-OARSI responder criteria
Per the OMERACT-OARSI criteria, a subject is classified as a positive responder if at least one (1) of the following two (2) conditions is observed at the post-baseline assessment:
In either pain (WOMAC pain subscale) or function (WOMAC function subscale), a high improvement in the subscale, where high improvement in a subscale is achieved if there is both a > 50% improvement from Baseline and an absolute change from Baseline of > 20 normalised units (0-100 scale) OR
Improvement in at least two (2) of the following three (3):
Improvement in pain (WOMAC pain subscale) defined as > 20% improvement from Baseline and an absolute change from Baseline of > 10 (0-100 scale)
Improvement in function (WOMAC function subscale) defined as > 20% improvement from Baseline and an absolute change from Baseline of > 10 (0-100 scale)
Improvement in PGA defined as > 20% improvement from Baseline and an absolute change from Baseline of > 10 mm (0-100 sc
Full Information
1. Study Identification
Unique Protocol Identification Number
NCT04045431
Brief Title
Treatment of Knee Osteoarthritis With PAAG-OA
Acronym
ROSA
Official Title
A Multi-centre Randomized, Controlled, Double-blind Clinical Investigation of Intra-articular Polyacrylamide Hydrogel in Subjects With Knee Osteoarthritis Followed by an Open Label Extension Study
Study Type
Interventional
2. Study Status
Record Verification Date
February 2023
Overall Recruitment Status
Active, not recruiting
Study Start Date
May 15, 2019 (Actual)
Primary Completion Date
October 1, 2020 (Actual)
Study Completion Date
November 30, 2026 (Anticipated)
3. Sponsor/Collaborators
Responsible Party, by Official Title
Sponsor
Name of the Sponsor
Contura
4. Oversight
Studies a U.S. FDA-regulated Drug Product
No
Studies a U.S. FDA-regulated Device Product
No
Data Monitoring Committee
No
5. Study Description
Brief Summary
This is a multi-center, randomized, double-blind clinical investigation to compare the effectiveness of intra-articular polyacrylamide hydrogel (PAAG-OA) and a hyaluronic acid, Synvisc-One to induce symptomatic benefit in subjects with knee osteoarthritis.
6. Conditions and Keywords
Primary Disease or Condition Being Studied in the Trial, or the Focus of the Study
Osteoarthritis, Knee
7. Study Design
Primary Purpose
Treatment
Study Phase
Not Applicable
Interventional Study Model
Parallel Assignment
Masking
ParticipantInvestigator
Masking Description
The subject and study staff will not know the treatment received. Only the unblinded injector will know the treatment.
Allocation
Randomized
Enrollment
238 (Anticipated)
8. Arms, Groups, and Interventions
Arm Title
PAAG-OA
Arm Type
Experimental
Arm Description
Intra-articular injection with PAAG-OA (polyacrylamide hydrogel)
Arm Title
Synvisc-One
Arm Type
Active Comparator
Arm Description
Intra-articular injection with Synvisc-One (hyaluronic acid)
Intervention Type
Device
Intervention Name(s)
PAAG-OA
Intervention Description
Intra-articular injection of 6ml PAAG-OA in the target knee (incl. five (5) years follow-up) period.
Intervention Type
Device
Intervention Name(s)
Synvisc-One
Intervention Description
Intra-articular injection of 6ml Synvisc-One in the target knee
Primary Outcome Measure Information:
Title
Comparing one injection of PAAG-OA with one injection of Synvisc-One on pain over 6 months in subjects with knee osteoarthritis
Description
Change in WOMAC (WOMAC Osteoarthritis Index) pain subscale. Pain is reported in each of five response categories (0=none, 4=extreme)
Time Frame
6 months
Secondary Outcome Measure Information:
Title
WOMAC
Description
WOMAC (WOMAC Osteoarthritis Index) self reported pain, stiffness and physical function, categories (0=none, 4=extreme)
Time Frame
1, 3, 6 and 12 months
Title
PGA (Patient Global Assessment)
Description
PGA reported on a 10 cm Visual Analogue Scale
Time Frame
1, 3, 6 and 12 months
Title
EQ-5D-5L, QoL
Description
EQ-5D-5L, Quality of Life, comprised of descriptive system where each dimension has 5 levels (ranging from no problems to extreme problems) and a 20 cm Visual Analogue Scale (0 = worst health and 100 = best health)
Time Frame
1, 3, 6 and 12 months
Title
OMERACT-OARSI responder criteria
Description
Per the OMERACT-OARSI criteria, a subject is classified as a positive responder if at least one (1) of the following two (2) conditions is observed at the post-baseline assessment:
In either pain (WOMAC pain subscale) or function (WOMAC function subscale), a high improvement in the subscale, where high improvement in a subscale is achieved if there is both a > 50% improvement from Baseline and an absolute change from Baseline of > 20 normalised units (0-100 scale) OR
Improvement in at least two (2) of the following three (3):
Improvement in pain (WOMAC pain subscale) defined as > 20% improvement from Baseline and an absolute change from Baseline of > 10 (0-100 scale)
Improvement in function (WOMAC function subscale) defined as > 20% improvement from Baseline and an absolute change from Baseline of > 10 (0-100 scale)
Improvement in PGA defined as > 20% improvement from Baseline and an absolute change from Baseline of > 10 mm (0-100 sc
Time Frame
1, 3, 6 and 12 months
10. Eligibility
Sex
All
Minimum Age & Unit of Time
40 Years
Accepts Healthy Volunteers
No
Eligibility Criteria
Inclusion Criteria:
Signed and dated informed consent form
Stated willingness to comply with all study procedures and availability for the duration of the study
Male or female, aged ≥ 40 years
Clinical diagnosis of knee OA American College of Rheumatology criteria confirmed by radiology
Definite radiographic OA in the most symptomatic knee (target knee) at mild to moderate-stage (Kellgren-Lawrence grades 2 or 3)
Stable dose of analgesics for the past four weeks
NRS (11 points (0-10) pain intensity numerical rating scale) ≥ 4 in target knee, during the past week when walking
Body Mass Index (BMI) between 20-35
For females of reproductive potential: use of adequate contraception must be used throughout the trial
Exclusion Criteria:
Female participants who are pregnant, lactating or planning pregnancy during the course of the clinical investigation
Contraindications to PAAG-OA or Synvisc-One®, according to IB or Instruction for Use (IFU)
Previous intra-articular injection of polyacrylamide gel in the target knee
Previous intra-articular injection with hyaluronic acid or derivatives in target knee in the previous 6 months
Significant valgus/varus deformity of the knee, ligamentous laxity or meniscal instability
Other diseases in target knee than osteoarthritis
Intra-articular injection of any substance other than hyaluronic acid (e.g. corticosteroids) in the target knee within the last 3 months
Acute serious infection of any region that required hospital care or intravenous antibiotic treatment within the last 30 days, or oral antibiotic treatment within the last 14 days
Skin disease or infections in the area of the injection site
Infected or severely inflamed knees
History of sepsis in any joint or any clinical concern for a subacute infectious process in the target knee
History of surgery in the target knee within the past 6 months
Symptomatic osteoarthritis of the hips, spine or ankle, that interferes with the evaluation of the target knee
Planned surgery on any lower extremity
Clinically significant venous or lymphatic stasis present in the legs
Clinically apparent tense effusion or inflammation in the target knee
Suffering from any unstable or severe cardio-vascular disease
Any contraindication to intra-articular e.g. anticoagulant therapy or clinical concern for potential coagulopathy (e.g. liver disease)
Any foreign material in the target joint
Any significant medical condition (e.g. significant psychiatric or neurological disorders or active alcohol/drug abuse), any medical condition that is unstable/poorly controlled or other factors that may interfere with study participation
Treatment with systemic steroids
History of drug/alcohol abuse, mental dysfunction of other factors limiting their ability to cooperate fully
Change in physiotherapy within the previous month
Fibromyalgia
Inflammatory or other disease/condition which may affect joints (e.g. rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis among others)
Haemophilia
Any other condition that in the opinion of the investigator put a potential participant at risk or otherwise precludes participation in the trial
Known allergic reactions to components of Synvisc-One (avian protein)
Known allergic reactions to antibiotics (azithromycin and moxifloxacin) or local anaesthesia
Participation in any experimental device study within 6 months prior to enrolment, or participation in an experimental drug study within 1 month prior to enrolment
Overall Study Officials:
First Name & Middle Initial & Last Name & Degree
Henning Bliddal, MD
Organizational Affiliation
The Parker Institute
Official's Role
Principal Investigator
Facility Information:
Facility Name
The Parker Institute
City
Frederiksberg
Country
Denmark
Facility Name
A2 Reumatologi og idrætsmedicin
City
Hillerød
Country
Denmark
Facility Name
Reumatolog i Odense
City
Odense
Country
Denmark
12. IPD Sharing Statement
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Treatment of Knee Osteoarthritis With PAAG-OA
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