Patient-Reported Outcomes in Evaluating Lorecivivint (SM04690) for Moderate to Severe Knee Osteoarthritis (STRIDES-1) (STRIDES-1)

A 28-Week, Multicenter, Randomized, Double-Blind, Placebo-Controlled Study to Evaluate a Single Injection of SM04690 Injected in the Target Knee Joint of Moderately to Severely Symptomatic Osteoarthritis Subjects

This phase 3 study is a multicenter, randomized, double-blind, placebo-controlled study of lorecivivint injected intraarticularly (IA) into the target knee (most painful) joint of moderately to severely symptomatic osteoarthritis (OA) subjects at a single dose of 0.07 mg lorecivivint per 2 mL injection. This study will utilize patient reported outcomes (PROs) to evaluate the safety and efficacy of lorecivivint.

Study Overview

• Status: Completed
• Conditions: Knee Osteoarthritis
• Intervention / Treatment: Drug: Lorecivivint; Drug: Placebo

Detailed Description

SM04690-OA-10 was a phase 3, 28-week multicenter, randomized, double-blind, placebo-controlled, parallel group study investigating the safety, tolerability and efficacy of lorecivivint 0.07 mg (compared with placebo) injected into the target knee joint of moderately to severely symptomatic knee OA subjects.

Patient-reported outcomes included Pain Numeric Rating Scale (NRS) [0-10], Western Ontario and McMaster Universities Arthritis Index (WOMAC), and Patient Global Assessment (PGA) of knee osteoarthritis.

The primary efficacy endpoint was change from baseline in target knee Pain NRS at Week 12. Secondary endpoints included change at Week 12 in WOMAC Function and PGA.

• Study Type: Interventional
• Enrollment (Actual): 496
• Phase: Phase 3

Contacts and Locations

Study Locations

• United States
  • Alabama
    • Birmingham, Alabama, United States, 35205
      • Research Site
    • Birmingham, Alabama, United States, 35215
      • Research Site
    • Mobile, Alabama, United States, 36608
      • Research Site
  • Arizona
    • Phoenix, Arizona, United States, 85018
      • Research Site
    • Phoenix, Arizona, United States, 85053
      • Research Site
    • Tucson, Arizona, United States, 85712
      • Research Site
  • Arkansas
    • Little Rock, Arkansas, United States, 72205
      • Research Site
  • California
    • Anaheim, California, United States, 92805
      • Research Site
    • Beverly Hills, California, United States, 90211
      • Research Site
    • Canoga Park, California, United States, 91303
      • Research Site
    • Garden Grove, California, United States, 92840
      • Research Site
    • La Mesa, California, United States, 91942
      • Research Site
    • Norco, California, United States, 92860
      • Research Site
    • Pomona, California, United States, 91767
      • Research Site
    • San Diego, California, United States, 92103
      • Research Site
    • Santa Monica, California, United States, 90404
      • Research Site
    • Thousand Oaks, California, United States, 91360
      • Research Site
    • Westminster, California, United States, 92683
      • Research Site
  • Colorado
    • Boulder, Colorado, United States, 80301
      • Research Site
  • Connecticut
    • Hamden, Connecticut, United States, 06517
      • Research Site
  • Florida
    • Clearwater, Florida, United States, 33761
      • Reserach Site
    • Edgewater, Florida, United States, 32132
      • Research Site
    • Gulf Breeze, Florida, United States, 32561
      • Research Site
    • Miami, Florida, United States, 33173
      • Research Site
    • Miami, Florida, United States, 33125
      • Research Site
    • Miami Lakes, Florida, United States, 33014
      • Research Site
    • Sunrise, Florida, United States, 33351
      • Research Site
    • Sweetwater, Florida, United States, 33172
      • Research Site
    • West Palm Beach, Florida, United States, 33409
      • Research Site
    • Winter Haven, Florida, United States, 33880
      • Research Site
    • Winter Park, Florida, United States, 32789
      • Research Site 1
  • Georgia
    • Marietta, Georgia, United States, 30060
      • Research Site
    • Newnan, Georgia, United States, 30265
      • Research Site
    • Woodstock, Georgia, United States, 30189
      • Research Site
  • Idaho
    • Boise, Idaho, United States, 83713
      • Research Site
  • Illinois
    • Chicago, Illinois, United States, 60607
      • Research Site
    • Gurnee, Illinois, United States, 60031
      • Research Site
    • Oak Brook, Illinois, United States, 60523
      • Research Site
  • Indiana
    • Evansville, Indiana, United States, 47714
      • Research Site
    • Greenwood, Indiana, United States, 46143
      • Research Site
    • Valparaiso, Indiana, United States, 46383
      • Research Site
  • Louisiana
    • New Orleans, Louisiana, United States, 70124
      • Research Site
  • Maryland
    • Wheaton, Maryland, United States, 20902
      • Research Site
  • Massachusetts
    • Boston, Massachusetts, United States, 02111
      • Research Site
  • Michigan
    • Troy, Michigan, United States, 48085
      • Research Site
  • Missouri
    • Hazelwood, Missouri, United States, 63042
      • Research Site
    • Kansas City, Missouri, United States, 64114
      • Research Site
    • St Louis, Missouri, United States, 63141
      • Research Site 1
    • St Louis, Missouri, United States, 63141
      • Research Site 2
  • Nebraska
    • Omaha, Nebraska, United States, 68114
      • Research Site
  • Nevada
    • Las Vegas, Nevada, United States, 89119
      • Research Site
    • Reno, Nevada, United States, 89519
      • Research Site
  • New Jersey
    • Freehold, New Jersey, United States, 07728
      • Research Site
  • New Mexico
    • Albuquerque, New Mexico, United States, 87102
      • Research Site
  • New York
    • Hartsdale, New York, United States, 10530
      • Research Site
    • Rochester, New York, United States, 14642
      • Research Site
  • North Carolina
    • Greensboro, North Carolina, United States, 27408
      • Research Site
    • Salisbury, North Carolina, United States, 28144
      • Research Site
    • Winston-Salem, North Carolina, United States, 27103
      • Research Site
  • Ohio
    • Cincinnati, Ohio, United States, 45224
      • Research Site
  • Oklahoma
    • Edmond, Oklahoma, United States, 73013
      • Research Site
  • Pennsylvania
    • Duncansville, Pennsylvania, United States, 16635
      • Research Site
  • South Carolina
    • Charleston, South Carolina, United States, 29406
      • Research Site
    • Fort Mill, South Carolina, United States, 29707
      • Research Site
    • Mt. Pleasant, South Carolina, United States, 29464
      • Research Site
  • South Dakota
    • Rapid City, South Dakota, United States, 57702
      • Research Site
  • Texas
    • Bellaire, Texas, United States, 77401
      • Research Site
    • Carrollton, Texas, United States, 75007
      • Research Site
    • Dallas, Texas, United States, 75231
      • Research Site
    • Houston, Texas, United States, 77029
      • Research Site
    • Plano, Texas, United States, 75075
      • Research Site
  • Utah
    • Draper, Utah, United States, 84020
      • Research Site
    • Ogden, Utah, United States, 84405
      • Research Site
    • Salt Lake City, Utah, United States, 84107
      • Research Site
  • Virginia
    • Charlottesville, Virginia, United States, 22911
      • Research Site
    • Richmond, Virginia, United States, 23219
      • Research Site

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 40 years to 80 years (Adult, Older Adult)
• Accepts Healthy Volunteers: No

Description

Key Inclusion Criteria:

• Males and females between 40 and 80 years of age, inclusive, in general good health apart from their knee OA
• Ambulatory (single assistive devices such as canes allowed if needed less than 50% of the time, subjects requiring a walker are excluded)
• Diagnosis of femorotibial OA in the target knee by standard American College of Rheumatology (ACR) criteria at the Screening Visit (clinical AND radiographic criteria); OA of the knee is not to be secondary to any rheumatologic conditions (e.g., rheumatoid arthritis)
• Radiographic disease Stage 2 or 3 in target knee within 24 weeks of the Screening Visit according to the Kellgren-Lawrence (KL) grading of knee OA as assessed by independent central readers
• Qualifying mean score on the 24-h average pain score (0-10 numeric rating scale)
• Pain compatible with OA of the knee(s) for at least 26 weeks prior to the Screening Visit
• Primary source of pain throughout the body is due to OA in the target knee
• Body mass index (BMI) ≤ 35 kg/m2 at the Screening Visit
• Negative drug test for amphetamine, buprenorphine, cocaine, methadone, opiates, phencyclidine (PCP), propoxyphene, barbiturates, benzodiazepine, methaqualone, and tricyclic antidepressants, unless any of these drugs are allowed per protocol and prescribed by a physician to treat a specific condition

Key Exclusion Criteria:

• Pregnant women, breastfeeding women, and women who are not post-menopausal (defined as 12 months with no menses without an alternative medical cause) or permanently surgically sterile (includes hysterectomy, bilateral salpingectomy, and bilateral oophorectomy) who have a positive or indeterminate pregnancy test result at the Screening Visit or Day 1
• Significant malalignment of anatomical axis (medial angle formed by the femur and tibia) of the target knee (varus > 10°, valgus > 10°) by radiograph within 24 weeks of the Screening Visit as assessed by independent central readers
• Partial or complete joint replacement in either knee
• Currently requires use of a lower extremity prosthesis, and/or a structural knee brace (i.e., a knee brace that contains hardware)
• Any surgery (e.g., arthroscopy) in either knee within 26 weeks prior to Day 1
• Intra-articular (IA) injection into the target knee with a therapeutic aim including, but not limited to hyaluronic acid, platelet-rich plasma (PRP), and stem cell therapies within 26 weeks prior to Day 1; or IA glucocorticoids within 12 weeks prior to Day 1 allowed
• Previous treatment with lorecivivint (SM04690)
• Subjects who have previously failed screening on this protocol and fail to meet re-screening criteria
• Participation in a clinical research trial that included the receipt of an investigational product or any experimental therapeutic procedure within 26 weeks prior to the Screening Visit, or planned participation in any such trial
• Subjects requiring the use of opioids > 1x per week within 12 weeks prior to Day 1
• History of malignancy within the last 5 years; not including subjects with prior history of adequately treated in situ cervical cancer or basal or squamous cell skin cancer
• Clinically significant abnormal screening hematology values, blood chemistry values, or urinalysis values as determined by the Investigator
• Any known active infections, including urinary tract infection, upper respiratory tract infection, sinusitis, suspicion of IA infection, hepatitis B or hepatitis C infection, and/or infections that may compromise the immune system such as human immunodeficiency virus (HIV) at Day 1

Study Plan

How is the study designed?

Design Details

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

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Lorecivivint; Healthcare professional-administered intra-articular injection; performed on Day 1.	Drug: Lorecivivint; One intra-articular injection of 0.07 mg lorecivivint in 2 mL vehicle; Other Names: SM04690
Active Comparator: Vehicle; Healthcare professional-administered intra-articular injection; performed on Day 1.	Drug: Placebo; One intra-articular injection of 0 mg lorecivivint in 2 mL vehicle; Other Names: Vehicle

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline OA Pain in the Target Knee as Assessed by the Weekly Average of Daily Pain Numeric Rating Scale (NRS) at Week 12	Evaluate change from baseline OA pain in the target knee as assessed by the weekly average of daily pain NRS at Week 12. The pain NRS is an 11-point scale [0-10] for subject self-reporting of average knee pain in the last 24 hours; 0 indicates no pain, and 10 represents the worst possible pain.	Baseline and Week 12

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Change From Baseline OA Pain in the Target Knee as Assessed by the Weekly Average of Daily Pain Numeric Rating Scale (NRS) at Week 24	Evaluate change from baseline OA pain in the target knee as assessed by the weekly average of daily pain NRS at Week 24. The pain NRS is an 11-point scale [0-10] for subject self-reporting of average knee pain in the last 24 hours; 0 indicates no pain, and 10 represents the worst possible pain.	Baseline and Week 24
Change From Baseline OA Function in the Target Knee as Assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Physical Function Subscore (WOMAC Function) at Week 12	Evaluate change from baseline OA function in the target knee as assessed by WOMAC Function subscore at Week 12. The WOMAC is a widely-used, proprietary outcome measurement tool used to evaluate the condition of subjects with OA of the knee and hip, including pain (5 questions), stiffness (2 questions), and physical functioning (17 questions) of the joints. Each question is measured on an 11-point numeric rating scale from 0 (lowest pain/lowest stiffness/highest function) to 10 (highest pain/highest stiffness/lowest function). The WOMAC Function raw subscore ranges from 0 to 170, and is scaled 0 (highest overall function) to 100 (lowest overall function) for analysis and reporting.	Baseline and Week 12
Change From Baseline OA Function in the Target Knee as Assessed by Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Physical Function Subscore (WOMAC Function) at Week 24	Evaluate change from baseline OA function in the target knee as assessed by WOMAC Function subscore at Week 24. The WOMAC is a widely-used, proprietary outcome measurement tool used to evaluate the condition of subjects with OA of the knee and hip, including pain (5 questions), stiffness (2 questions), and physical functioning (17 questions) of the joints. Each question is measured on an 11-point numeric rating scale from 0 (lowest pain/lowest stiffness/highest function) to 10 (highest pain/highest stiffness/lowest function). The WOMAC Function raw subscore ranges from 0 to 170, and is scaled 0 (highest overall function) to 100 (lowest overall function) for analysis and reporting.	Baseline and Week 24
Change From Baseline OA Disease Activity as Assessed by Patient Global Assessment at Week 12	Evaluate change from baseline OA disease activity as assessed by Patient Global Assessment at Week 12. The Patient Global Assessment is an 11-point [0-10] Numeric Rating Scale [NRS] on which the subjects will rate how they feel their target knee OA is doing, considering all the ways in which their target knee OA may affect them. The NRS is anchored by descriptors at each end ("Very Good" on the left and "Very Bad" on the right). For analysis, Patient Global Assessment scores were scaled to [0-100], where 0 represents "Very Good" and 100 represents "Very Bad".	Baseline and Week 12
Change From Baseline OA Disease Activity as Assessed by Patient Global Assessment at Week 24	Evaluate change from baseline OA disease activity as assessed by Patient Global Assessment at Week 24. The Patient Global Assessment is an 11-point [0-10] Numeric Rating Scale [NRS] on which the subjects will rate how they feel their target knee OA is doing, considering all the ways in which their target knee OA may affect them. The NRS is anchored by descriptors at each end ("Very Good" on the left and "Very Bad" on the right). For analysis, Patient Global Assessment scores were scaled to [0-100], where 0 represents "Very Good" and 100 represents "Very Bad".	Baseline and Week 24

Collaborators and Investigators

• Sponsor: Biosplice Therapeutics, Inc.
• Investigators: Study Director: Yusuf Yazici, M.D., Biosplice Therapeutics, Inc.

Publications and helpful links

General Publications

• Tambiah J, Kennedy S, Swearingen C, McAlindon T, Yazici Y. Impact of structural severity on outcomes in knee osteoarthritis: an analysis of data from phase 2 and phase 3 lorecivivint clinical trials. Rheumatology (Oxford). 2025 May 1;64(5):2583-2590. doi: 10.1093/rheumatology/keae610.

Study record dates

Study Major Dates

• Study Start (Actual): May 26, 2020
• Primary Completion (Actual): September 8, 2021
• Study Completion (Actual): September 8, 2021

Study Registration Dates

• First Submitted: May 8, 2020
• First Submitted That Met QC Criteria: May 8, 2020
• First Posted (Actual): May 12, 2020

Study Record Updates

• Last Update Posted (Actual): February 4, 2026
• Last Update Submitted That Met QC Criteria: January 20, 2026
• Last Verified: January 1, 2026

More Information

Terms related to this study

• Keywords: osteoarthritis; Samumed; SM04690; Wnt pathway inhibitor; lorecivivint
• Additional Relevant MeSH Terms: Musculoskeletal Diseases; Arthritis; Joint Diseases; Rheumatic Diseases; Osteoarthritis; Osteoarthritis, Knee; Anti-Inflammatory Agents; lorecivivint
• Other Study ID Numbers: SM04690-OA-10

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: Yes
• Studies a U.S. FDA-regulated device product: No