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A Study to Evaluate the Clinical Performance and Safety of an Intra-articular Hyaluronic Acid in Knee Osteoarthritis

Phase 3
Completed
Conditions
Knee Osteoarthritis
Interventions
Device: Placebo
Registration Number
NCT03200288
Lead Sponsor
IBSA Institut Biochimique SA
Brief Summary

This is a study to evaluate the Clinical Performance and Safety of a single intra-articular (i.a.) injection of hyaluronic acid product (as HL-01) in the treatment of pain due to osteoarthritis (OA) of the knee.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
692
Inclusion Criteria
  • Female and male subjects ≥40 to 80 years of age.
  • Subjects with primary knee OA of the medial or lateral femoro-tibial compartment, documented according to ACR criteria with symptoms, at screening, from at least 3 months.
  • Subjects with Kellgren & Lawrence (K-L) radiological grade 2-3.
  • Subjects with at least one antero-posterior view X-Ray image of the target knee taken within 12 months prior to the screening.
  • Subjects with OA pain intensity meeting the criteria below:

If unilateral knee OA: Subjects demonstrating at screening pain intensity in the target knee measured by Visual Analogue Scale (VAS) ≥40 mm VAS, and ≤ 20 mm in the contralateral knee and confirmed at randomization after wash-out from analgesics/NSAIDs.

If bilateral knee OA: definition of the most symptomatic joint at screening based on subject's evaluation and Investigator's clinical judgment with subjects demonstrating pain intensity in the target knee measured by Visual Analogue Scale (VAS) ≥40 mm VAS, and ≤ 20mm in the contralateral knee and confirmed at randomization after wash-out from analgesics/NSAIDs.

  • Subjects are able to understand and are willing and able to comply with study procedures including usage of acetaminophen as the only analgesic.
  • Subjects are able to provide informed consent.
  • Any female subject of childbearing potential must agree to use adequate methods of contraception throughout the course of the study.
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Exclusion Criteria
  • Subjects with secondary (post-traumatic) knee OA of the target and non-target joints.

  • Subjects with K-L radiological grade 4 knee OA.

  • Subjects with a history of knee joint replacement/arthroplasty of the target knee.

  • Subjects with a history of arthroscopy, osteotomy, or surgery of the target knee in the past 12 months.

  • Subjects with any significant injury to the target knee in the last 6 months (as per Investigator judgment).

  • Subjects with Body Mass Index (BMI) ≥32 kg/m2.

  • Subjects with any musculoskeletal condition affecting the target knee that would impair proper assessment of the Investigational Medicinal Device (IMD) performance in the target knee as assessed by the Investigator and such as:

    1. severe varus/valgus deformity (>15°)
    2. predominantly patello-femoral pain/syndrome.
  • Subjects with a history of symptomatic hip OA or other health condition i.e. associated with pain and interfering with adequate study endpoints evaluation.

  • Subjects with a known history or present evidence of conditions which may affect the target knee assessments, like rheumatic disease and inflammatory, infective or metabolic joint diseases; recurrent clinical chondrocalcinosis; crystal arthropathies; osteo-articular pathologies differing from arthrosis; articular fracture; ochronosis; acromegaly; haemochromatosis; Wilson's disease; primary osteochondromatosis; heritable disorders; collagen gene mutations.

  • Subjects with venous or lymphatic stasis in the relevant limb.

  • Subjects with a history of the following treatments for knee OA:

    a) I. a. knee corticosteroids: i. target knee - in the past 3 months ii. non-target knee/other joints - in the past 4 weeks b) Systemic (both oral and parenteral) and topical corticosteroids at the target knee in the past 3 months.

    c) Topical anti-inflammatories and analgesics applied at the target knee in the past 48 hrs.

    d) Viscosupplementation with hyaluronic acid or joint-lavage in the target knee in the past year.

    e) Physical therapy started in the last 3 months in the target knee. f) Symptomatic Slow-Acting Drugs for OA (SYSADOA) such as glucosamine, chondroitin sulfate, diacerhein, or other medications like avocado/soya extracts, etc. in the past 3 months.

    g) Chronic or recurrent use of narcotic analgesics. h) Use of analgesic (other than acetaminophen) and NSAIDs for a time of 5-half-lives before the screening.

  • Subjects with a history of chronic or recurrent use of NSAIDs/analgesics/narcotics because of diseases different from OA of the target knee.

  • Subjects treated with drugs having an influence on pain: hypnotics, muscle relaxants, anxiolytics if the intake has started less than 8 days before the screening.

  • Subjects who currently use heparin or anti-vitamin K (e. g. crystalline warfarin) anticoagulant therapy.

  • Subjects with the presence of infection, skin diseases, other disease or trauma in the area of the injection site or joint.

  • Subjects with a known history or suspected allergy or hypersensitivity to hyaluronic acid or to hyaluronate preparations.

  • Subjects with a known history or suspected allergy or hypersensitivity to acetaminophen.

  • Subjects with any major surgery scheduled in the next 6 months.

  • Subjects who have participated in a clinical study / investigation in the last 3 months.

  • Pregnant or lactating women and women of childbearing potential not willing to use adequate contraception.

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Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
PlaceboPlaceboSingle 2 ml intra-articular injection of Placebo (physiological solution)
Primary Outcome Measures
NameTimeMethod
Change in VAS (Visual Analogue Scale) pain scoreBaseline-week 24

The primary efficacy variable will be the change from baseline of the VAS pain score calculated as a VAS measure ranging from 0 to 100 mm. A four- step analysis will be followed in order to assess superiority of HL-01 versus Placebo after 6, 12, 18 and 24 weeks.

Secondary Outcome Measures
NameTimeMethod
Change in global status assessed by physicianBaseline -Week 24

Change from baseline in global status assessed by physician at 6, 12, 18 and 24 weeks (5-point verbal Likert scale), dichotomised to 'Improvement' and 'No change/Worsening'

Change in global status assessed by subject (EQ-5D-5L EuroQol Group Health questionnaire)Baseline-Week 24

Change from baseline in global status assessed by subject at 6, 12, 18 and 24 weeks (EQ-5D-5L)

Change in Lequesne's Algofunctional IndexBaseline-Week 24

Change from baseline in Lequesne's Algofunctional Index at 6, 12, 18 and 24 weeks.

Rescue medication usageWeek 6-Week 24

Rescue medication usage assessed at 6, 12, 18 and 24 weeks.

Overall response rate according to OMERACT (Outcome Measures in Rheumatology)-OARSI (Osteoarthritis Research Society International) criteriaWeek 6-Week 24

Overall response rate according to OMERACT-OARSI criteria at 6, 12, 18 and 24 weeks (this is a statistical analysis)

Trial Locations

Locations (31)

Ospedale San Pietro - FATEBENEFRATELLI

🇮🇹

Roma, Italy

Klinische Forschung Berlin-Mitte GmbH

🇩🇪

Berlin, Germany

NZOZ VITAMED Gałaj i Cichomski Sp. j.

🇵🇱

Bydgoszcz, Poland

Istituto Ortopedico Gaetano Pini

🇮🇹

Milano, Italy

Rheumazentrum Prof. Dr. med. Gunther Neeck

🇩🇪

Bad Doberan, Germany

DGS Schmerzzentrum Eichstätt

🇩🇪

Eichstätt, Germany

AmBeNet GmbHDas Ambulante BehandlungsNetz

🇩🇪

Leipzig, Germany

Fisiatria Policlinico di Napoli

🇮🇹

Napoli, Italy

ETG Lublin

🇵🇱

Lublin, Poland

ETG Warszawa

🇵🇱

Warszawa, Poland

ETG Zamość

🇵🇱

Zamość, Poland

Wasilczyk Medical Clinic Indywidualna Praktyka Lekarska Cezary Wasilczyk

🇵🇱

Warszawa, Poland

ETG Łódź

🇵🇱

Łódź, Poland

Klinika Zdrowej Kości

🇵🇱

Łódź, Poland

Lubelskie Centrum Diagnostyczne

🇵🇱

Świdnik, Poland

SOLB - Zbigniew Zegota

🇵🇱

Ostróda, Poland

Europejskie Centrum Leczenia Chorób Cywilizacyjnych

🇵🇱

Warszawa, Poland

CHU Centre Ville (Brull) - Bone Metabolism Unit

🇧🇪

Liège, Belgium

DEEK University

🇭🇺

Debrecen, Hungary

Revita Rendelő

🇭🇺

Budapest, Hungary

Semmelweis Egyetem - Ortopediai Klinika

🇭🇺

Budapest, Hungary

Swan Med SMO

🇭🇺

Létavértes, Hungary

Szent Margit Rendelőintézet

🇭🇺

Budapest, Hungary

MEDIDEA Egeszsegugyi es Szolgaltato Beteti Tarsasag

🇭🇺

Kiskunfélegyháza, Hungary

ETG Chełm

🇵🇱

Chełm, Poland

ETG Siedlce

🇵🇱

Siedlce, Poland

NZOZ Wilmed

🇵🇱

Warszawa, Poland

Centrum Medyczne Lukamed

🇵🇱

Chojnice, Poland

Centrum Kliniczno-Badawcze

🇵🇱

Elbląg, Poland

RCMed

🇵🇱

Sochaczew, Poland

Gdańskie Centrum Zdrowia

🇵🇱

Gdańsk, Poland

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