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

A Phase 3 Randomized, Double-blind, Multi-Dose, Placebo-Controlled Study to Evaluate the Long-Term Safety and the Efficacy of Fasinumab in Patients With Pain Due to Osteoarthritis of the Knee or Hip

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.

Study Overview

• Status: Completed
• Conditions: Osteoarthritis of the Knee or Hip
• Intervention / Treatment: Drug: Fasinumab; Drug: Placebo

• Study Type: Interventional
• Enrollment (Actual): 5331
• Phase: Phase 3

Contacts and Locations

Study Locations

• Bulgaria
  • Burgas, Bulgaria, 8000
    • Regeneron Investigational Site
  • Plovdiv, Bulgaria, 4000
    • Regeneron Investigational Site #1
  • Plovdiv, Bulgaria, 4002
    • Regeneron Investigational Site #2
  • Plovdiv, Bulgaria, 4004
    • Regeneron Investigational Site #3
  • Sofia, Bulgaria, 1000
    • Regeneron Investigational Site #1
  • Sofia, Bulgaria, 1612
    • Regeneron Investigational Site #2
  • Stara Zagora, Bulgaria, 6000
    • Regeneron Investigational Site
• Chile
  • Santiago, Chile, 8331143
    • Regeneron Investigational Site
• Colombia
  • Bogota, Colombia, 110221
    • Regeneron Investigational Site
  • Medellin, Colombia, 50003
    • Regeneron Investigational Site
• Denmark
  • Aalborg, Denmark, 9000
    • Regeneron Investigational Site
  • Ballerup, Denmark, 2750
    • Regeneron Investigational Site
  • Vejle, Denmark, DK 7100
    • Regeneron Investigational Site
• Estonia
  • Paide, Estonia, 72713
    • Regeneron Investigational Site
  • Tallinn, Estonia, 10128
    • Regeneron Investigational Site
• Germany
  • Berlin, Germany, 1267
    • Regeneron Investigational Site
  • Bochum, Germany, 44787
    • Regeneron Investigational Sites
  • Frankfurt, Germany, 60313
    • Regeneron Investigational Site
  • Magdeburg, Germany, 39120
    • Regeneron Investigational Site
  • Sachsen
    • Leipzig, Sachsen, Germany, 04103
      • Regeneron Investigational Site
• Hong Kong
  • Central, Hong Kong
    • Regeneron Investigational Site
• Hungary
  • Budapest, Hungary, 1036
    • Regeneron Investigational Site
  • Debrecen, Hungary, 4025
    • Regeneron Investigational Site
  • Gyula, Hungary, 5700
    • Regeneron Investigational Site
  • Hatvan, Hungary, 3000
    • Regeneron Investigational Site
  • Zalaegerszeg, Hungary, 8900
    • Regeneron Investigational Site
• Italy
  • Firenze, Italy, 50139
    • Regeneron Investigational Site
  • Naples, Italy, 80138
    • Regeneron Investigational Site
• Lithuania
  • Alytus, Lithuania, LT-62114
    • Regeneron Investigational Site
  • Kaunas, Lithuania, 48259
    • Regeneron Investigational Site
  • Vilnius, Lithuania, 10323
    • Regeneron Investigational Site
  • Šiauliai, Lithuania, LT-76231
    • Regeneron Investigational Site
• Mexico
  • Baja Californina
    • Mexicali, Baja Californina, Mexico, 21100
      • Regeneron Investigational Site
  • Ciudad De Mexico
    • Cuauhtemoc, Ciudad De Mexico, Mexico, 06700
      • Regeneron Investigational Site
    • Cuauhtémoc, Ciudad De Mexico, Mexico, 06700
      • Regeneron Investigational Site
  • DF
    • Distrito Federal, DF, Mexico, 03100
      • Regeneron Investigational Site
  • Distrito Federal
    • Mexico, Distrito Federal, Mexico, 11850
      • Regeneron Investigational Site
  • Jalisco
    • Guadalajara, Jalisco, Mexico, 44160
      • Regeneron Investigational Site
    • Guadalajara, Jalisco, Mexico, 44660
      • Regeneron Investigational Site
  • Mexico City
    • Cuauhtemoc, Mexico City, Mexico, 06100
      • Regeneron Investigational Site
  • Morelos
    • Cuernavaca, Morelos, Mexico, 62290
      • Regeneron Investigational Site
  • Sinaloa
    • Culiacan, Sinaloa, Mexico, 80000
      • Regeneron Investigational Site
  • Yucatan
    • Merida, Yucatan, Mexico, 97000
      • Regeneron Investigational Site
    • Merida, Yucatan, Mexico, C.P. 97070
      • Regeneron Investigational Site
• Peru
  • Lima, Peru, 27
    • Regeneron Investigational Site
• Poland
  • Gdańsk, Poland, 80-382
    • Regeneron Investigational Site
  • Gdynia, Poland, 81-537
    • Regeneron Investigational Site
  • Katowice, Poland, 40-040
    • Regeneron Investigational Site
  • Kraków, Poland, 31-501
    • Regeneron Investigational Site
  • Poznań, Poland, 60-702
    • Regeneron Investigational Site
  • Warszawa, Poland, 01-192
    • Regeneron Investigational Site #1
  • Warszawa, Poland, 01-192
    • Regeneron Investigational Site #2
  • Wrocław, Poland, 50-381
    • Regeneron Investigational Site
  • Łódź, Poland, 90-368
    • Regeneron Investigational Site
• Romania
  • Bucharest, Romania, 021611
    • Regeneron Investigational Site #2
  • Bucharest, Romania, 30463
    • Regeneron Investigational Site #1
• Russian Federation
  • Kazan', Russian Federation, 420012
    • Regeneron Investigational Site
  • Novosibirsk, Russian Federation, 630091
    • Regeneron Investigational Site
  • Samara, Russian Federation, 443095
    • Regeneron Investigational Site
  • Tomsk, Russian Federation, 634050
    • Regeneron Investigational Site
  • Yaroslavl, Russian Federation, 150003
    • Regeneron Investigational Site #2
  • Yaroslavl, Russian Federation, 150007
    • Regeneron Investigational Site #1
• South Africa
  • Bloemfontein, South Africa, 9301
    • Regeneron Investigational Site
  • Cape Town, South Africa, 7530
    • Regeneron Investigational Site
  • Kempton Park, South Africa, 1619
    • Regeneron Investigational Site
  • Parow, South Africa, 7500
    • Regeneron Investigational Site
  • Port Elizabeth, South Africa, 6001
    • Regeneron Investigational Site
  • Pretoria, South Africa, 0122
    • Regeneron Investigational Site
  • Roodepoort, South Africa, 1724
    • Regeneron Investigational Site
  • Somerset West, South Africa, 7130
    • Regeneron Investigational Site
  • Soweto, South Africa, 1818
    • Regeneron Investigational Site
  • Gauteng
    • Pretoria, Gauteng, South Africa, 0184
      • Regeneron Investigational Site #1
    • Pretoria, Gauteng, South Africa, 0184
      • Regeneron Investigational Site #2
• Spain
  • A Coruna, Spain, 15006
    • Regeneron Investigational Site
  • Barcelona, Spain, 08025
    • Regeneron Investigational Site
  • Madrid, Spain, 28100
    • Regeneron Investigational Site
  • Sevilla, Spain, 41010
    • Regeneron Investigational Site
• Sweden
  • Boras, Sweden, 50630
    • Regeneron Investigational Site
  • Goteburg, Sweden, 413 45
    • Regeneron Investigational Site
  • Helsingborg, Sweden, 25220
    • Regeneron Investigational Site
  • Linkoping, Sweden, 587 58
    • Regeneron Investigational Site
  • Lund, Sweden, 222 22
    • Regeneron Investigational Site
  • Uppsala, Sweden, 75237
    • Regeneron Investigational Site
  • Vällingby, Sweden, 16268
    • Regeneron Investigational Site
  • Skane
    • Malmo, Skane, Sweden, 211 52
      • Regeneron Investigational Site
• Ukraine
  • Cherkasy, Ukraine, 18009
    • Regeneron Investigational Site
  • Kyiv, Ukraine, 02002
    • Regeneron Investigational Site #3
  • Kyiv, Ukraine, 03037
    • Regeneron Investigational Site #1
  • Kyiv, Ukraine, 03049
    • Regeneron Investigational Site #2
  • Lviv, Ukraine, 79495
    • Regeneron Investigational Site
• United Kingdom
  • Birmingham, United Kingdom, B15 2SQ
    • Regeneron Investigational Site
  • Chorley, United Kingdom, PR7 7NA
    • Regeneron Investigational Site
  • Glasgow, United Kingdom, G20 0SP
    • Regeneron Investigational Site
  • Hexham, United Kingdom, NE46 1QJ
    • Regeneron Investigational Site
  • Liverpool, United Kingdom, L22 0LG
    • Regeneron Investigational Site
  • Manchester, United Kingdom, M15 6SE
    • Regeneron Investigational Site
  • Middlesex, United Kingdom, HA6 2RN
    • Regeneron Investigational Site
  • Reading, United Kingdom, RG2 0TG
    • Regeneron Investigational Site
  • Romford, United Kingdom, RM1 3PJ
    • Regeneron Investigational Site
  • Sidcup, United Kingdom, DA14 6LT
    • Regeneron Investigational Site
• United States
  • Alabama
    • Birmingham, Alabama, United States, 35211
      • Regeneron Investigational Site
  • Arizona
    • Chandler, Arizona, United States, 85224
      • Regeneron Investigational Site #1
    • Chandler, Arizona, United States, 85224
      • Regeneron Investigational Site #2
    • Glendale, Arizona, United States, 85308
      • Regeneron Investigational Site
    • Mesa, Arizona, United States, 85213
      • Regeneron Investigational Site
    • Phoenix, Arizona, United States, 85018
      • Regeneron Investigational Site (4 locations)
    • Tempe, Arizona, United States, 85224
      • Regeneron Investigational Site
    • Tucson, Arizona, United States, 85712
      • Regeneron Investigational Site (2 locations)
  • Arkansas
    • Little Rock, Arkansas, United States, 72205
      • Regeneron Investigational Site
  • California
    • Beverly Hills, California, United States, 90211
      • Regeneron Investigational Site
    • Carlsbad, California, United States, 92008
      • Regeneron Investigational Site
    • San Diego, California, United States, 92103
      • Regeneron Investigational Site
    • San Marcos, California, United States, 92078
      • Regeneron Investigational Site
    • Vista, California, United States, 92083
      • Regeneron Investigational Site
  • Colorado
    • Aurora, Colorado, United States, 80014
      • Regeneron Investigational Site
    • Colorado Springs, Colorado, United States, 80909
      • Regeneron Investigational Site
    • Golden, Colorado, United States, 80401
      • Regeneron Investigational Site
    • Littleton, Colorado, United States, 80127
      • Regeneron Investigational Site
  • Florida
    • Clearwater, Florida, United States, 33765
      • Regeneron Investigational Site
    • Orlando, Florida, United States, 32801
      • Regeneron Investigational Site
    • Pinellas Park, Florida, United States, 33781
      • Regeneron Investigational Site
  • Georgia
    • Atlanta, Georgia, United States, 30328
      • Regeneron Investigational Site
  • Illinois
    • Chicago, Illinois, United States, 60602
      • Regeneron Investigational Site (3 locations)
    • Evansville, Illinois, United States, 47714
      • Regeneron Investigational Site
  • Kansas
    • Kansas City, Kansas, United States, 64114
      • Regeneron Investigational Site
  • Maryland
    • Frederick, Maryland, United States, 21702
      • Regeneron Investigational Site
  • Massachusetts
    • Worcester, Massachusetts, United States, 01605
      • Regeneron Investigational Site
  • Minnesota
    • Richfield, Minnesota, United States, 55423
      • Regeneron Investigational Site
  • Missouri
    • Saint Louis, Missouri, United States, 63141
      • Regeneron Investigational Site #1
    • Saint Louis, Missouri, United States, 63141
      • Regeneron Investigational Site #2
  • Nebraska
    • Elkhorn, Nebraska, United States, 68022
      • Regeneron Investigational Site
    • Fremont, Nebraska, United States, 68025
      • Regeneron Investigational Site
    • Omaha, Nebraska, United States, 68144
      • Regeneron Investigational Site
  • Nevada
    • Las Vegas, Nevada, United States, 89128
      • Regeneron Investigational Site
  • New York
    • Jamaica, New York, United States, 11432
      • Regeneron Investigational Site
    • New York, New York, United States, 10036
      • Regeneron Investigational Site
  • North Carolina
    • High Point, North Carolina, United States, 27262
      • Regeneron Investigational Site
  • Ohio
    • Akron, Ohio, United States, 44311
      • Regeneron Investigational Site
    • Cincinnati, Ohio, United States, 45219
      • Regeneron Investigational Site
    • Columbus, Ohio, United States, 43212
      • Regeneron Investigational Site
  • Oklahoma
    • Oklahoma City, Oklahoma, United States, 73119
      • Regeneron Investigational Site
  • Pennsylvania
    • Duncansville, Pennsylvania, United States, 16635
      • Regeneron Investigational Site
  • South Carolina
    • Anderson, South Carolina, United States, 29621
      • Regeneron Investigational Site
    • Greer, South Carolina, United States, 29651
      • Regeneron Investigational Site
  • Texas
    • Dallas, Texas, United States, 75234
      • Regeneron Investigational Site #1
    • Dallas, Texas, United States, 75234
      • Regeneron Investigational Site #2
    • Houston, Texas, United States, 77008
      • Regeneron Investigational Site
    • Lubbock, Texas, United States, 79424
      • Regeneron Investigational Site
    • Plano, Texas, United States, 75093
      • Regeneron Investigational Site
    • San Antonio, Texas, United States, 78229
      • Regeneron Investigational Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Key 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 Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Quadruple

Number of Arms

3

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Placebo	Drug: Placebo; Participants will receive sub-cutaneous (SC) injections of matching placebo
Experimental: Fasinumab dosing regimen 1	Drug: Fasinumab; Participants will receive sub-cutaneous (SC) injections of fasinumab; Other Names: REGN475
Experimental: Fasinumab dosing regimen 2	Drug: Fasinumab; Participants will receive sub-cutaneous (SC) injections of fasinumab; Other Names: REGN475

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Number of Participants With Any Treatment-Emergent Adverse Event (TEAE)		Baseline up to week 52
Number of Participants With Any Serious TEAE		Baseline up to week 52
Number of Participants With Any Adverse Event (AE) up to Week 72		Baseline up to week 72
Number of Participants With Any Serious AE up to Week 72		Baseline up to week 72
Number of Participants With Adjudicated Arthropathy (AA)	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.	Baseline up to week 52 and week 72
Number of Participants With Adjudicated Arthropathy (AA) Meeting Destructive Arthropathy (DA) Criteria	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.	Baseline up to week 52 and week 72
Number of Participants With at Least One Peripheral Sensory Event That Required a Neurology Consultation	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).	Baseline up to week 72
Number of Participants With Sympathetic Nervous System (SNS) Dysfunction	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.	Baseline up to week 72
Number of Participants With at Least One All-Cause Joint Replacement (JR) Surgery	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.	Baseline up to weeks 52, 72, and end of study (52 weeks post last dose)
Number of Participants With Potentially Clinically Significant Abnormal Laboratory Values up 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.	Baseline to week 52
Number of Participants With Potentially Clinically Significant Abnormal Laboratory Values Post-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.	End of treatment up to week 72
Number of Participants With Anti-drug Antibody (ADA) 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.	Baseline up to week 72
Change From Baseline to Week 16 in the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Pain Subscale Score	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.	Baseline to Week 16
Change From Baseline to Week 16 in WOMAC Physical Function Subscale Score	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.	Baseline to Week 16

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline to Week 16 in Patient Global Assessment (PGA) Score of Osteoarthritis	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).	Baseline to Week 16
Number of Participants With ≥30% Reduction From Baseline to Week 16 in the WOMAC Pain Subscale Score	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	Baseline to Week 16

Collaborators and Investigators

• Sponsor: Regeneron Pharmaceuticals
• Collaborators: Teva Pharmaceutical Industries, Ltd.
• Investigators: Study Director: Clinical Trial Management, Regeneron Pharmaceuticals

Study record dates

Study Major Dates

• Study Start (Actual): February 17, 2016
• Primary Completion (Actual): December 1, 2020
• Study Completion (Actual): June 15, 2021

Study Registration Dates

• First Submitted: January 28, 2016
• First Submitted That Met QC Criteria: February 16, 2016
• First Posted (Estimated): February 17, 2016

Study Record Updates

• Last Update Posted (Actual): October 13, 2023
• Last Update Submitted That Met QC Criteria: October 11, 2023
• Last Verified: October 1, 2023

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases; Arthritis; Osteoarthritis; Osteoarthritis, Knee; Physiological Effects of Drugs; Peripheral Nervous System Agents; Analgesics; Sensory System Agents; Analgesics, Non-Narcotic; Fasinumab
• Other Study ID Numbers: R475-PN-1523; 2015-003783-36 (EudraCT Number)

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No