- ICH GCP
- US Clinical Trials Registry
- Clinical Trial NCT04210986
Senolytic Drugs Attenuate Osteoarthritis-Related Articular Cartilage Degeneration: A Clinical Trial
December 29, 2023 updated by: Steadman Philippon Research Institute
Phase I/II randomized, double-blind, placebo-controlled clinical trial to test the safety and efficacy of Fisetin for treating mild to moderate osteoarthritis
Study Overview
Status
Completed
Conditions
Intervention / Treatment
Detailed Description
This is a Phase I/II randomized, double-blind, placebo-controlled clinical trial that will be conducted at The Steadman Clinic (TSC) and Steadman Philippon Research Institute (SPRI).
The purpose of this study is to evaluate the clinical efficacy of Fisetin (FIS), a dietary supplement, in symptomatic knee osteoarthritis (OA) patients.
Key aspects of this proposal include the investigator's well-developed methodologies to measure and compare systemic senescence-associated secretory phenotype (SASP) including inflammatory biomarkers and senescent cells, and collect magnetic resonance images, self-reported outcomes, physical performance and other objective clinical data.
Given the drug FIS has been empirically demonstrated to reduce senescent cell burden, the main objective(s) are to determine 1) the safety of FIS during dosing and 2) whether FIS reduces senescent cells, pro-inflammatory and cartilage degenerating SASP markers, and reduces OA-symptoms leading to improved joint health and function.
Study Type
Interventional
Enrollment (Actual)
75
Phase
- Phase 2
- Phase 1
Contacts and Locations
This section provides the contact details for those conducting the study, and information on where this study is being conducted.
Study Locations
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Colorado
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Vail, Colorado, United States, 81657
- The Steadman Clinic
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Participation Criteria
Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.
Eligibility Criteria
Ages Eligible for Study
40 years to 80 years (Adult, Older Adult)
Accepts Healthy Volunteers
No
Description
Inclusion Criteria:
Subjects will be included if all the following criteria are met:
- Are male or female, ages 40-80;
- Are willing to comply with all study related procedures and assessments;
- Are ambulatory as defined by ability to complete functional performance testing;
- Radiographic evidence of Kellgren-Lawrence grade II-IV osteoarthritis in one or both knees;
- Scores 4-10 on the Numerical Rating Scale (NRS) for pain;
- Stable dose of screening/baseline medications for at least 2 months prior to the anticipated date of study drug dosing.
Exclusion Criteria:
Subjects will be excluded if any of the following criteria are met:
- Females who are nursing, pregnant or planning to become pregnant during the duration of study drug dosing;
- Males who do not wish to abstain from sex or use contraceptive protection during study drug dosing and for 2 weeks after the last dose;
- Subjects who do not have the capacity to consent themselves;
- Subjects who are unable to tolerate oral medication;
Subjects having previously undergone any of the following treatments in the stated time window.
- Surgery on the Study Knee in the past 6 months;
- Partial or complete joint replacement in the study knee. Partial or complete joint replacement in the contralateral knee is acceptable as long as the surgery was performed at least 6 months prior to enrollment and the operative knee is asymptomatic;
- Patients who have undergone arthroscopic surgery (including microfracture and meniscectomy) on the Study Knee in the last 2 years prior to the Screening visit or are anticipated to have arthroscopic surgery on either knee at any time during the study period;
- Steroid injection, including extended-release corticosteroid (e.g., Zilretta®) within the last 5 months;
- Biologic (platelet-rich plasma, bone marrow, adipose tissue/cells) or hyaluronic acid injection into the Study Knee in the past 6 months;
Subjects with any of the following drug/medication statuses:
- Currently taking Losartan;
- Currently taking Warfarin or related anticoagulants;
- Opioid analgesics taken in the past 8 weeks and are not willing to discontinue these medications through the duration of the study;
- Senolytic agents taken within the past 6 months and are not willing to discontinue these medications through the duration of the study, including: Fisetin, Quercetin, Luteolin, Dasatinib, Piperlongumine, or Navitoclax;
- Drugs that induce significant cellular stress and are not willing to discontinue these medications through the duration of the study, including alkylating agents, anthracyclines, platins, other chemotherapy drugs;
- Subjects taking the following other drugs if they cannot be held (per the Principal Investigator) for at least 2 days before and during administration of Fisetin: cyclosporine, tacrolimus, repaglinide, and bosentan.
Subjects with any of the following disease statuses:
- Significant liver disease (i.e. greater than or equal to 2x the upper limit of normal bilirubin levels) or as in the opinion of the Principal Investigator;
- Significant renal disease (eGFR of <60 ml/min/1.73m2) or as in the opinion of the Principal Investigator;
- History of other formally diagnosed joint diseases including osteonecrosis, acromegaly, Paget's disease, Ehlers-Danlos Syndrome, Gaucher's disease, Cushing's syndrome, Stickler's syndrome, joint infection, hemophilia, hemochromatosis, or neuropathic arthropathy of any cause;
- Any active systemic autoimmune disease with musculoskeletal involvement or any history of system inflammatory arthritis;
- Patients with type 1 or 2 diabetes (HbA1c>6.5%) and/or taking medications that affect insulin levels, including: Metformin (within the last week), Glucocorticoids (within the last month), Acarbose (within the last week);
- Subjects unable to safely practically undergo an MRI (BMI > 40 kg/m2) or size exceeding limits of MRI equipment, implanted metal in study knee near joint surface, incompatible implant/device, severe claustrophobia;
- Subjects that have any medical condition, including laboratory findings and findings in the medical history or in the pre-study assessments, that in the opinion of the Investigator constitutes a risk or contraindication for participation in the study or that could interfere with the study objectives, conduct or evaluation or prevent the patient from fully participating in all aspects of the study.
Study Plan
This section provides details of the study plan, including how the study is designed and what the study is measuring.
How is the study designed?
Design Details
- Primary Purpose: Treatment
- Allocation: Randomized
- Interventional Model: Parallel Assignment
- Masking: Quadruple
Arms and Interventions
Participant Group / Arm |
Intervention / Treatment |
---|---|
Experimental: Fisetin
Fisetin 100 mg capsules (~20 mg/ kg/ day) will be administered orally for two consecutive days (days 1 and 2) followed by 28 days off.
A second course will be given for two consecutive days (days 31 and 32)
|
Fisetin will be administered orally at 20 mg/kg for two consecutive days, followed by 28 days off, then 2 more consecutive days.
Other Names:
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Placebo Comparator: Placebo
Placebo capsules will be administered orally for two consecutive days (days 1 and 2) followed by 28 days off.
A second course will be given for two consecutive days (days 31 and 32)
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Placebo will be administered orally for two consecutive days, followed by 28 days off, then 2 more consecutive days.
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What is the study measuring?
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Incidence of Treatment-Emergent Adverse Events
Time Frame: Duration of study, an average of 12 months
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Occurrence of adverse events
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Duration of study, an average of 12 months
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Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
---|---|---|
Change in levels of pro-inflammatory markers associated with Senescence
Time Frame: Baseline, 14 days, 45 days, 6 months, 12 months (post 1st drug dose)
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Detection of inflammatory markers in peripheral blood using multiplex protein analyte analysis
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Baseline, 14 days, 45 days, 6 months, 12 months (post 1st drug dose)
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Change in levels of cartilage degenerating markers associated with OA
Time Frame: Baseline, 14 days, 45 days, 6 months, 12 months (post 1st drug dose)
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Detection of cartilage degenerating markers in peripheral blood using multiplex protein analyte analysis
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Baseline, 14 days, 45 days, 6 months, 12 months (post 1st drug dose)
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Change in physical function of the Study Knee (6 min walk)
Time Frame: Baseline, 6 months, and 12 months (post 1st drug dose)
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6-min walk test
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Baseline, 6 months, and 12 months (post 1st drug dose)
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Change in physical function of the Study Knee (timed-up-and-go test)
Time Frame: Baseline, 6 months, and 12 months (post 1st drug dose)
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timed-up-and-go test
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Baseline, 6 months, and 12 months (post 1st drug dose)
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Change in physical function of the Study Knee (fast 40-meter walk)
Time Frame: Baseline, 6 months, and 12 months (post 1st drug dose)
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fast 40-meter walk test
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Baseline, 6 months, and 12 months (post 1st drug dose)
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Change in physical function of the Study Knee (LEK)
Time Frame: Baseline, 6 months, and 12 months (post 1st drug dose)
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Lower Extremity Kinematics
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Baseline, 6 months, and 12 months (post 1st drug dose)
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Change in physical function of the Study Knee (Chair Test)
Time Frame: Baseline, 6 months, and 12 months (post 1st drug dose)
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Stair-Climbing Test
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Baseline, 6 months, and 12 months (post 1st drug dose)
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Change in muscle strength (Isokinetic Dynamometry)
Time Frame: Baseline, 6 months, and 12 months (post 1st drug dose)
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Isokinetic Dynamometry
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Baseline, 6 months, and 12 months (post 1st drug dose)
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Evaluation of patient reported outcomes (PROs) for knee pain
Time Frame: Baseline, every 3 days for the first 6-weeks of drug dosing, every week the last 6 weeks of dosing, then 6 months, 12 months, and 18 months
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NRS pain scale
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Baseline, every 3 days for the first 6-weeks of drug dosing, every week the last 6 weeks of dosing, then 6 months, 12 months, and 18 months
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Evaluation of patient reported outcomes (PROs) for knee function
Time Frame: Baseline, every 3 days for the first 6-weeks of drug dosing, every week the last 6 weeks of dosing, then 6 months, 12 months, and 18 months
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IKDC, WOMAC, Tegner activity scale and Lysholm
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Baseline, every 3 days for the first 6-weeks of drug dosing, every week the last 6 weeks of dosing, then 6 months, 12 months, and 18 months
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Change in the quality of articular cartilage in the Study Knee with quantitative magnetic resonance imaging (MRI)
Time Frame: Baseline, 6 months, and 12 months (post 1st drug dose)
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Quantitative MRI using T2 and/or T2* mapping images
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Baseline, 6 months, and 12 months (post 1st drug dose)
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Change in time to conversion to alternative treatment
Time Frame: Patients will be allowed to receive a steroid injection at any point during the 18-month study. The time to resort to this alternative therapy from baseline will be recorded.
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Patients will be allowed to receive a steroid injection and still participate in the study.
The time to resort to this alternative therapy from baseline will be recorded.
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Patients will be allowed to receive a steroid injection at any point during the 18-month study. The time to resort to this alternative therapy from baseline will be recorded.
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Collaborators and Investigators
This is where you will find people and organizations involved with this study.
Investigators
- Principal Investigator: Thomas A Evans, MD, The Steadman Clinic
Study record dates
These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.
Study Major Dates
Study Start (Actual)
January 6, 2020
Primary Completion (Actual)
January 5, 2023
Study Completion (Actual)
February 1, 2023
Study Registration Dates
First Submitted
December 3, 2019
First Submitted That Met QC Criteria
December 20, 2019
First Posted (Actual)
December 26, 2019
Study Record Updates
Last Update Posted (Estimated)
January 18, 2024
Last Update Submitted That Met QC Criteria
December 29, 2023
Last Verified
December 1, 2023
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
- 2019-16
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
NO
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Yes
Studies a U.S. FDA-regulated device product
No
This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.
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