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Tregocel® as a Dietary Supplement in Mild Knee Osteoarthritis

Not Applicable
Completed
Conditions
Mild Knee Osteoarthritis
Interventions
Dietary Supplement: Tregocel®
Registration Number
NCT03636035
Lead Sponsor
Max Biocare Pty. Ltd.
Brief Summary

This study is an assessment of the overall performance of participants with symptomatic mild knee OA taking Tregocel® as a dietary supplement in addition to standard of care treatment.

Detailed Description

Tregocel® is a combination herbal product which as a dietary supplementation may help maintain proper performance of joints. Although some studies have reported beneficial effects for individual components of Tregocel®, there have been no clinical assessments of supplementation with Tregocel® as a finished product. This study will involve collection of data on Tregocel® supplementation in participants with symptomatic mild knee osteoarthritis (OA) who are already receiving standard pharmacological treatment.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
150
Inclusion Criteria
  • Compliance with all study procedures
  • Fulfilment of consent process
  • Documented diagnosis of radiologically confirmed mild knee osteoarthritis with stable pain management (including patello-femoral joint, Kellgren-Lawrence classification ≤2 and clinical symptoms lasting more than 6 months prior to screening)
  • Maximal pain score ≥30 on a 100 mm VAS at screening and confirmed at baseline, with PRN use of analgesics during run-in
  • Completed patient diary during run-in
  • Ambulant with ECOG score <2
Exclusion Criteria
  • pregnancy or breastfeeding (women)
  • body mass index less than 18.5 kg/m^2 or more than 35.0 kg/m^2.
  • secondary knee OA
  • clinically apparent tense effusion of the target knee
  • valgus/varus knee/foot deformities, ligament laxity, or meniscal instability
  • changes in regular OA therapy during screening
  • chronic diseases which may require treatment with systemic steroids
  • progressive serious medical conditions
  • severe organ dysfunction
  • cardiac insufficiency
  • history of gastrointestinal ulcer or bleeding.
  • any significant medical conditions that may interfere with the study procedures, safety, compliance or overall participation in the study
  • allergies or intolerance to any of the dietary supplement ingredients

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Tregocel® supplementationTregocel®Tregocel® coated tablets (2/day) orally for 36 weeks
Primary Outcome Measures
NameTimeMethod
Change in distance walked in 6-minutes as an indicator of AMBULATORY MOBILITYTested at Baseline (week 0) and at end of supplementation (week 36)

Challenge involves subject walking unimpeded along a continuous straight line of 30 metre in distance with no incline. Distance covered will by an assistant sured with a 30 metre metric tape measure. Laps and time will be tracked manually with a digital lap counter and timer (second). Baseline values will be compared to values after supplementation to determine any change in individual performance.

Secondary Outcome Measures
NameTimeMethod
Physical exam parameter 2: SUBJECT HEIGHT measurementScreening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Body height measured manually using a wall tape measure (recorded in metre). Weight and height values will be used to calculate body mass index \[weight (kilogram) / height (metre) \^2\]

Vital sign 2: BLOOD PRESSUREScreening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Systolic and diastolic blood pressure values will be determined using an automated sphygnomanometer after 5 minutes rest, sedentary (recorded in millimeter mercury).

Arthritis self-assessment 2: change in degree of PERCEIVED PAIN represented by manual marking on a printed 100mm linear scale (During and after supplementation) in response to WOMAC questionnaireScores taken at baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Subject responds to a request to report degree of pain experienced in 48 hours in target knee by pen or pencil marking along a 100mm horizontal line (0mm (left) = no pain; 100mm (right) = extreme pain; more pain = closer to right hand end of line). Length from 0mm to mark will be measured using a 300mm ruler. Report includes degree of pain felt while stationary or during normal movement (a set of 5 subscales appearing as separate lines with the same limits). Marks appearing between the centre of the line and 100mm limit are considered between moderate and severe, with more severe toward the right. Total score is a sum of the 5 subscales (range 0-500mm). WOMAC = Western Ontario and McMaster Universities Arthritis index.

Arthritis self-assessment 3: change in degree of PERCEIVED STIFFNESS represented by manual marking on a printed 100mm linear scale (During and after supplementation) in response to WOMAC questionnaire.Scores taken at baseline (0 week); rescored at 12, 24, 36 and 40 weeks

Subject responds to a request to report feeling of stiffness experienced in 48 hours in target knee by pen or pencil marking along a 100mm horizontal line (0mm (left) = no stiffness; 100mm (right) = extreme stiffness; more pain = closer to right hand end of line). Length from 0mm to mark will be measured using a 300mm ruler, to indicate the degree of stiffness felt at start and end of a day (a set of 2 subscales, appearing as separate lines with the same limits). Marks appearing from the centre of the line to 100mm limit are considered between moderate and severe, with more severe toward the right. Total score is a sum of the 2 subscales (range 0-200mm).

Arthritis self-assessment 1: Initial degree of PERCEIVED PAIN represented by manual marking on a simplified printed 100mm linear scale (during Run-in)Run-in period (week -1 to week 0)

Subject responds to a request to report maximal pain experienced in 48 hours in target knee by pen or pencil marking along a 100mm line scale (0mm (left) = no pain; 100mm (right) = extreme pain; marks closer to right indicate more pain). Length from 0mm to mark will be measured using a 300mm ruler, to indicate the degree of maximal pain felt. No subscales are included in this assessment. Marks appearing between centre of the line and 100mm limit are considered moderate to severe (total score range = 0-100mm)

Safety assessment 1: clinical HEMATOLOGY parameters (c) sodium levelPerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Blood sodium initially and any subsequent changes to be determined using a blood gas analyser (mM)

Safety assessment 1: clinical HEMATOLOGY parameters (d) potassium levelPerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Blood sodium initially and any subsequent changes to be determined using a blood gas analyser (mM)

Safety assessment 1: clinical HEMATOLOGY parameters (g) total bilirubin levelPerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Blood bilirubin initially and any subsequent changes to be determined using ELISA assay (IU/L).

Safety assessment 1: clinical HEMATOLOGY parameters (h) alkaline phosphatase levelPerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Alkaline phosphatase level initially and any subsequent changes to be determined using ELISA assay (IU/L).

Physical exam parameter 1: BODY WEIGHT measurementScreening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Body weight measure using digital scales (recorded in kilogram).

Vital sign 1: BODY TEMPERATUREScreening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Measured using a digital ear thermometer after 5 minutes rest, sedentary.(recorded in degree Celsius)

Arthritis self-assessment 4: change in degree of PERCEIVED DIFFICULTY WITH DAILY TASKS represented by manual marking on a printed 100mm linear scale (During and after supplementation) in response to WOMAC questionnaire.Scores taken at baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Subject responds to a request to report difficult in performing daily tasks in 48 hours due to arthritis in target knee by pen or pencil marking along a 100mm horizontal line (0mm (left) = no pain; 100mm (right) = extreme pain; more pain = closer to right hand end of line). Length from 0mm to mark will be measured using a 300mm ruler, to indicate the degree of difficulty experienced in different domestic activities (set of 17 subscales, appearing as separate lines with the same limits). Marks appearing between the centre of the line to 100mm limit are considered between moderate and severe, with more severe toward the right. Total score is a sum of the 17 subscales (range 0-1700mm).

Change in target KNEE FLEXIBILITY assessment, based on heel-thigh distance and knee angle at maximal flexion.Scores taken supine and prone for both knees at baseline (week 0); rescored at 12, 24, 36 weeks

Subjects will lie either supine or prone while holding their target knee statically as close to their thigh as is bearable. Distance from heal to thigh (standard tape measurement) and angle of knee (measured using a goniometer) will be recorded.

Safety assessment 2: URINALYSIS (a) presence of leukocytesPerformed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested initially and any subsequent changes determined colorimetrically (negative = grey, positive = increase in purple color intensity).

Safety assessment 2: URINALYSIS (j) glucose levelPerformed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested and measured, and subsequent changes determined colorimetrically for content of glucose (absence = blue-green; presence = range form 100 (green) to \> 2000 mg/dL (dark brown).

Determination of total usage of PRESCRIPTION ANALGESICSScreening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Usage of any analgesics will be recorded on a daily basis by subjects using diary, which will be reviewed at clinical consultation. Total consumption will be logged at the end of the supplemention period as an indicator of changes in reliance on prescribed medications. (expressed as number of medications per day, regardless of type).

Vital sign 3: PULSE RATEScreening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Recorded using an automated sphygnomanometer after 5 minutes rest, sedentary (beats / minute)

Safety assessment 1: clinical HEMATOLOGY parameters (e) aspartate alanine transferase levelPerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Blood aspartate alanine transferase initially and any subsequent changes to be determined using ELISA assay (IU/L)

Safety assessment 1: clinical HEMATOLOGY parameters (i) creatine levelPerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Creatine level initially and any subsequent changes to be determined using ELISA assay (IU/L).

Safety assessment 1: clinical HEMATOLOGY parameters (j) blood sodiumPerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Sodium level initially and any subsequent changes to be determined using a blood gas analyser (mM).

Safety assessment 2: URINALYSIS (c) level of urobilinogenPerformed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested initially and any subsequent changes determined colorimetrically (normal = 0.2-1 mg/dL, yellow; raised = 2-8 mg/dL, with increasing pink intensity).

Safety assessment 2: URINALYSIS (d) presence of proteinPerformed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested initially and any subsequent changes determined colorimetrically (none or trace amounts (quince); raised = increased darkness of green pigment)

Safety assessment 2: URINALYSIS (e) pHPerformed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested initially and any subsequent changes determined colorimetrically (dual pigment assay, represented by color change from fading of orange (pH 5) to increased darkness of green pigment (pH 8.5).

Safety assessment 2: URINALYSIS (f) presence of bloodPerformed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested initially and any subsequent changes determined colorimetrically (none = yellow; trace amounts of non-hemolysed blood (dark-green speckle discoloration on a yellow background); presence of hemolysed blood (increasing darkness of green pigment on yellow background).

Safety assessment 1: clinical HEMATOLOGY parameters (a) Blood cell countPerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Number erythrocytes leukocytes and platelets initially and changes thereafter determined using an automated blood sample analyser (number x 10\^9/litre)

Safety assessment 1: clinical HEMATOLOGY parameters (f) alanine aminotransferasePerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Blood alanine aminotransferase level initially and any subsequent changes to be determined using ELISA assay (IU/L)

Safety assessment 1: clinical HEMATOLOGY parameters (b) hemoglobin levelPerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Hemoglobin will be measured initially and any subsequent changes determined using UV/Vis spectrometry (g/dL).

Safety assessment 2: URINALYSIS (g) specific gravity (SG)Performed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested initially and any subsequent changes determined colorimetrically (Dark green = 1.000, yellow-green = 1.030; increasing SG correlates with decreasing darkness of green pigment.

Safety assessment 2: URINALYSIS (h) ketone levelPerformed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested initially and any subsequent changes determined colorimetrically (none = beige; trace (pink = 5, increasing to large (160) mg/dL with increasing darkness of burgundy pigment)

Safety assessment 2: URINALYSIS (k) presence of human chorionic gonadotrophin (hCG)Performed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested and measured colorimetrically for presence of hCG (positive test = appearance of blue line on white background; negative = remains white).

Safety assessment 1: clinical HEMATOLOGY parameters (k) blood potassiumPerformed at screening (week -2), baseline (week 0); rescored at 12, 24, 36 and 40 weeks

Potassium level initially and any subsequent changes to be determined using a blood gas analyser (mM).

Safety assessment 2: URINALYSIS (b) presence of nitritesPerformed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested initially and any subsequent changes determined colorimetrically (negative = yellow, positive = increase in pink color intensity).

Safety assessment 2: URINALYSIS (i) presence of bilirubinPerformed at screening (week -2), baseline (Week 0); rescored at 12, 24, 36 and 40 weeks

Urine will be dipstick tested initially and any subsequent changes determined colorimetrically (negative = yellow; increasing levels correlate with appearance of light brown pigment).

Trial Locations

Locations (1)

Clinmed Pharma

🇵🇱

Warsaw, Poland

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