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Clinical Trials/NCT04638387
NCT04638387TerminatedNot Applicable

Nuclear Factor Erythroid 2-Related Factor 2 (Nrf2) Activation, Mobility, and Energetics: A Pilot and Feasibility Clinical Trial of PB125 Treatment for Improving Musculoskeletal and Pain Outcomes in Osteoarthritis

Colorado State University2 sites in 1 country4 target enrollmentStarted: November 3, 2020Last updated:
Conditions

Trial Snapshot

Phase
Not Applicable
Status
Terminated
Enrollment
4
Locations
2
Primary Endpoint
Mobility-6 min fast-paced walk

Study Overview

Brief Summary

Nuclear factor erythroid 2-related factor 2 (Nrf2) is an important regulator in the body. It controls how well cells protect themselves against stress. PB125 (Pathways Bioscience) is a plant based activator of this important regulator Nrf2. PB125 is made up of three plant extracts (rosemary, ashwagandha, and Sophora japonica) so that it contains these things; 1. Carnosol, 2. Withaferin A, and 3. Luteolin. Carnosol comes from rosemary leaves. Rosemary is a spice often used in Italian foods and grown in many herb gardens all around Fort Collins. Withaferin A comes from the medicinal plant Withania somnifera, also called ashwagandha. Ashwaganda is commonly known as "Indian Winter cherry" or "Indian Ginseng" and it is one of the most important herbs of Ayurveda (the traditional system of medicine in India) used for millennia. Finally, luteolin is found widely in plants including those present in the diet (peppers, onions, celery, herbs/spices). Some people purchase these herbs commercially, and take them on their own for a variety of purposes. Typically, when you buy them, they will be in much higher doses than they are in PB125. What makes PB125 different is that very low doses of each of the 3 components work together-synergistically-to activate Nrf2 and increase the ability of cells to respond to stress. It is unknown if there are any benefits to taking PB125 and the risks are currently unknown. The purpose of this study is to examine changes in muscle, in joint pain, in mobility (standing and walking) and in leg strength that occur after consuming PB125 every day for 3 months. We want to make these measurements in people who have been diagnosed with mild to moderate osteoarthritis-a degenerative joint disease-in their knees.

Detailed Description

Preventing or slowing age-related decline in musculoskeletal function is important for maintaining mobility and independence. In the US, osteoarthritis (OA) is the primary cause of disability in adults, with no medical or surgical therapeutic intervention known to restore the degenerated cartilage. The loss of skeletal muscle mass and function with age, is also linked to increased risk of other diseases, risk of falls, and decreased quality of life. Therefore, OA and muscle loss together are primary contributors to age-related decreases in mobility and independence. Evidence suggests a decrease in muscle quality is associated with or precedes primary knee OA, suggesting that these two conditions may share a common cause. We will treat 50-65 year old people with mild or moderate OA in both knees, and reported loss of muscle strength, with a supplement already available for use in humans to reduce oxidative stress and inflammation. The supplement is called PB125. In this pilot clinical trial, we will measure the ability of muscle to make energy, measure mobility (walking and standing) and strength, and assess pain following PB125 or placebo treatment.

Study Design

Study Type
Interventional
Allocation
Non Randomized
Intervention Model
Single Group
Primary Purpose
Treatment
Masking
Double (Participant, Outcomes Assessor)

Masking Description

Participants will not know if they are receiving PB125 or placebo. Participants will complete pain surveys. Team members making measurements of mobility and mitochondrial energetics will not know if participants or samples are PB125 or placebo.

Eligibility Criteria

Ages
50 Years to 65 Years (Adult, Older Adult)
Sex
All
Accepts Healthy Volunteers
No

Inclusion Criteria

  • bilateral knee osteoarthritis

Exclusion Criteria

  • pregnant/breastfeeding
  • known liver, renal, heart disease, diabetes, autoimmune disease, cancer
  • use of methotrexate, etanercept, infliximab, leflunomide, plaquenil
  • recent serious illness
  • intraarticular stem cell injection
  • intraarticular steroid or hyaluronic acid injection within 4 months
  • current enrollment in another trial of investigational drugs
  • known hypersensitivity to ashwagandha, luteolin, rosemary, or rice flour
  • use of anticoagulants or known bleeding disorder
  • unwillingness to comply with protocol
  • plans for knee replacement in the next 3 years
  • unable to complete mobility testing without ambulatory aid
  • unable to climb 1-2 flights or stairs without stopping/shortness of breath/discomfort
  • blood product transfusion within 30 days
  • unable to provide legal consent

Outcomes

Primary Outcomes

Mobility-6 min fast-paced walk

Time Frame: Change from baseline at 12 weeks

Change in Distance walked

Energetics-Maximal Oxygen Consumption

Time Frame: Change from baseline at 12 weeks

Change in O2 flux in permeabilized muscle fibers at maximal ADP concentrations

Mobility-6 min self-paced walk

Time Frame: Change from baseline at 12 weeks

Change in Distance walked

Mobility-sit to stand

Time Frame: Change from baseline at 12 weeks

Change in Time for 5 sit to stand repetitions

Mobility-static balance

Time Frame: Change from baseline at 12 weeks

Yes/No ability to complete 30 sec trials with eyes open or closed on firm and foam surfaces

Intermittent and Constant Knee Pain

Time Frame: Change weekly for 12 weeks

Weekly change in Intermittent and Constant Pain Score (ICOAP) 11 question survey of pain on a 0-4 scale

Energetics-Submaximal Oxygen Consumption

Time Frame: Change from baseline at 12 weeks

Change in oxygen (O2) flux in permeabilized muscle fibers at submaximal adenosine diphosphate (ADP) concentrations

Secondary Outcomes

  • Energetics-hydrogen peroxide emission(Change from baseline at 12 weeks)
  • Knee Range of Motion(Change from baseline at 12 weeks)
  • Leg extensor strength(Change from baseline at 12 weeks)
  • Bone Mineral Density(Change from baseline at 12 weeks)

Investigators

Sponsor Class
Other
Responsible Party
Principal Investigator
Principal Investigator

Karyn Hamilton

Professor

Colorado State University

Study Sites (2)

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