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Long-Term Safety and Efficacy Study of Fasinumab in Patients With Pain Due to Osteoarthritis (OA) of the Knee or Hip

Phase 3
Completed
Conditions
Osteoarthritis of the Knee or Hip
Interventions
Drug: Placebo
Registration Number
NCT02683239
Lead Sponsor
Regeneron Pharmaceuticals
Brief Summary

The primary objective of the study is to describe the safety and tolerability of fasinumab, including adverse events of special interest (AESIs), in patients with pain due to radiographically-confirmed OA of the knee or hip.

Detailed Description

Not available

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
5331
Inclusion Criteria
  1. Male or female ≥18 years of age at the screening visit
  2. Clinical diagnosis of OA of the knee or hip based on the American College of Rheumatology criteria with radiologic evidence of OA (K-L score ≥2) for the index joint at the screening visit
  3. Moderate to severe pain in the index joint defined as a Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) average pain subscale score of ≥4
  4. A history of 12 weeks of analgesic use for OA of the knee or hip
  5. History of regular use of analgesic medications for OA pain

Key

Exclusion Criteria
  1. History or presence at the screening visit of non OA inflammatory joint disease
  2. History or presence on imaging of arthropathy, stress fracture, recent stress fracture, neuropathic joint arthropathy, hip dislocation, knee dislocation, congenital hip dysplasia with degenerative joint disease, extensive subchondral cysts, evidence of bone fragmentation or collapse, or primary metastatic tumor with the exception of chondromas or pathologic fracture during the screening period
  3. Signs or symptoms of carpal tunnel syndrome within 6 months of screening
  4. Patient is not a candidate for MRI
  5. Is scheduled for a joint replacement surgery to be performed during the study period
  6. Systemic (i.e., oral or intramuscular) corticosteroids within 30 days prior to the screening visit.
  7. History or presence at the screening visit of multiple sclerosis, autonomic neuropathy, diabetic neuropathy, or other peripheral neuropathy, including reflex sympathetic dystrophy
  8. History or diagnosis of chronic autonomic failure syndrome including pure autonomic failure, multiple system atrophy
  9. Pregnant or breast-feeding women
  10. Women of childbearing potential who have a positive pregnancy test result or do not have their pregnancy test result at baseline

Note: Other protocol defined Inclusion/Exclusion criteria apply

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
Fasinumab dosing regimen 1Fasinumab-
Fasinumab dosing regimen 2Fasinumab-
PlaceboPlacebo-
Primary Outcome Measures
NameTimeMethod
Number of Participants With Any Adverse Event (AE) up to Week 72Baseline up to week 72
Number of Participants With Any Serious AE up to Week 72Baseline up to week 72
Number of Participants With Any Serious TEAEBaseline up to week 52
Number of Participants With at Least One Peripheral Sensory Event That Required a Neurology ConsultationBaseline up to week 72

Any participant with a peripheral sensory event that persisted for 2 months was referred for a neurology or other specialty consultation and reported as an adverse event of special interest (AESI).

Number of Participants With Any Treatment-Emergent Adverse Event (TEAE)Baseline up to week 52
Number of Participants With Adjudicated Arthropathy (AA) Meeting Destructive Arthropathy (DA) CriteriaBaseline up to week 52 and week 72

DA is a unique clinical form of rapidly destructive arthropathy over and above that seen in the normal progression of OA. DA criteria can be associated with Rapidly Progressive OA type 2, Subchondral Insufficiency fracture, and Primary Osteonecrosis confirmed by an arthropathy adjudication committee.

Number of Participants With Sympathetic Nervous System (SNS) DysfunctionBaseline up to week 72

Potential events of sympathetic nervous system (SNS) dysfunction were monitored throughout the study through physical examination, AE reporting, assessment of orthostatic hypotension, and the Survey of Autonomic Symptoms. Sympathetic nervous system dysfunction was diagnosed after consultation with an appropriate specialist, such as a neurologist and/or cardiologist.

Number of Participants With at Least One All-Cause Joint Replacement (JR) SurgeryBaseline up to weeks 52, 72, and end of study (52 weeks post last dose)

All joint replacement surgery events regardless of cause at weeks 52 and 72. An end of study phone contact was also conducted approximately 52 weeks following the last dose of study drug.

Number of Participants With Potentially Clinically Significant Abnormal Laboratory Values up to Week 52Baseline to week 52

Number of participants with potentially clinically significant abnormal values in hematology, chemistry, and urinalysis during the treatment period were reported. Clinical significance was determined by the investigator.

Number of Participants With Potentially Clinically Significant Abnormal Laboratory Values Post-Treatment up to Week 72End of treatment up to week 72

Number of participants with potentially clinically significant abnormal values in hematology, chemistry, and urinalysis during the post-treatment period were reported. Clinical significance was determined by the investigator.

Number of Participants With Anti-drug Antibody (ADA) up to Week 72Baseline up to week 72

Immunogenicity was characterized by ADA responses \& titers. Responses categories: Negative - ADA negative response at all time points, regardless of missing samples; Pre-existing immunoreactivity - ADA positive response at baseline with all post first dose negative results or positive response at baseline with all post first dose ADA responses less than (\<) 9-fold over baseline titer levels; Treatment-boosted response - positive response in the assay post first dose, greater than or equal to (≥) 9-fold over baseline titer levels, when baseline results are positive; Treatment-emergent response - ADA positive response in the fasinumab ADA assay post first dose when baseline results = negative or missing.

Number of Participants With Adjudicated Arthropathy (AA)Baseline up to week 52 and week 72

Adjudicated arthropathy (AA) is a composite term that encompasses the following conditions: Rapidly progressive OA type 1 and 2, Subchondral insufficiency fractures, and Primary Osteonecrosis. AAs were also evaluated to determine if they met Destructive Arthropathy criteria.

Change From Baseline to Week 16 in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Pain Subscale ScoreBaseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Change From Baseline to Week 16 in WOMAC Physical Function Subscale ScoreBaseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations.

Secondary Outcome Measures
NameTimeMethod
Change From Baseline to Week 16 in Patient Global Assessment (PGA) Score of OsteoarthritisBaseline to Week 16

The PGA of OA is a patient-rated assessment of current disease state on a 5-point Likert scale (1 = very good; 2 = good; 3 = fair; 4 = poor; and 5 = very poor).

Number of Participants With ≥30% Reduction From Baseline to Week 16 in the WOMAC Pain Subscale ScoreBaseline to Week 16

The WOMAC index is comprised of 24 parameters grouped in 3 subscales (pain-5 questions, physical function -17 questions and stiffness - 2 questions), with 0-10 grading of each question. The scores for each subscale are summed up, divided by number of questions, and each subscale is reported using Numerical Rating Scale score of 0-10. In addition to subscales, a total score is provided as the sum of normalized subscale scores divided by three, and reported using a Numerical Rating Scale score of 0-10. Higher scores indicate worse pain, stiffness and functional limitations. Participants who achieved a response, where response was defined as an improvement by ≥30% in WOMAC pain subscale score

Trial Locations

Locations (8)

Regeneron Investigational Site (4 locations)

🇺🇸

Phoenix, Arizona, United States

Regeneron Investigational Site

🇬🇧

Sidcup, United Kingdom

Regeneron Investigational Site #1

🇺🇦

Kyiv, Ukraine

Regeneron Investigational Site #2

🇺🇦

Kyiv, Ukraine

Regeneron Investigational Site (3 locations)

🇺🇸

Chicago, Illinois, United States

Regeneron Investigational Site (2 locations)

🇺🇸

Tucson, Arizona, United States

Regeneron Investigational Site #3

🇺🇦

Kyiv, Ukraine

Regeneron Investigational Sites

🇩🇪

Bochum, Germany

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