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To Determine the Safety, Tolerability, Pharmacokinetics and Effect on Pain of a Single Intra-articular Administration of Canakinumab in Patients With Osteoarthritis in the Knee

28 de septiembre de 2012 actualizado por: Novartis Pharmaceuticals

A Randomized, Double Blind, Placebo and Naproxen Controlled, Multi-center, Study to Determine the Safety, Tolerability, Pharmacokinetics and Effect on Pain of a Single Intra-articular Administration of Canakinumab in Patients With Osteoarthritis in the Knee

The purpose of this study was to determine whether, in patients with mild to moderate knee osteoarthritis, canakinumab is safe and tolerable when injected intra-articularly.

Descripción general del estudio

Descripción detallada

This is a randomized, double-blind, parallel group, placebo controlled 18 weeks study, consisting of two parts:

  1. Part A: an ascending single dose part in which the safety and tolerability of up to 4 different canakinumab doses are studied (starting dose 150 mg, maximum dose 600 mg).
  2. Part B: a double-dummy, active-controlled, parallel design part in which the pain reduction of the canakinumab dose selected from part A is studied in comparison to Placebo and Naproxen.

Tipo de estudio

Intervencionista

Inscripción (Actual)

169

Fase

  • Fase 2

Contactos y Ubicaciones

Esta sección proporciona los datos de contacto de quienes realizan el estudio e información sobre dónde se lleva a cabo este estudio.

Ubicaciones de estudio

      • Berlin, Alemania
        • Novartis Investigative Site
      • Erlangen, Alemania
        • Novartis Investigative Site
    • Alabama
      • Anniston, Alabama, Estados Unidos, 36207
        • Pinnacle Research Group, LLC
    • Arizona
      • Mesa, Arizona, Estados Unidos, 85202
        • Arizona Arthritis & Rheumatology Research, PLLC
    • California
      • San Diego, California, Estados Unidos, 92108
        • San Diego Arthritis & Osteoporosis Medical Clinic
      • Westlake Village, California, Estados Unidos, 91361
        • Westlake Medical Research
    • Illinois
      • Chicago, Illinois, Estados Unidos, 60612
        • Rush-Presbyterian St. Lukes Medical Center
    • Kansas
      • Topeka, Kansas, Estados Unidos, 66606
        • Cotton O'Neil Clinical Research Institute
    • Pennsylvania
      • Duncansville, Pennsylvania, Estados Unidos, 16635
        • Altoona Center for Clinical Research
    • Tennessee
      • Knoxville, Tennessee, Estados Unidos, 37920
        • Volunteer Research Group
      • Helsinki, Finlandia
        • Novartis Investigative Site
      • Kuopio, Finlandia
        • Novartis Investigative Site
      • Creteil, Francia
        • Novartis Investigative Site

Criterios de participación

Los investigadores buscan personas que se ajusten a una determinada descripción, denominada criterio de elegibilidad. Algunos ejemplos de estos criterios son el estado de salud general de una persona o tratamientos previos.

Criterio de elegibilidad

Edades elegibles para estudiar

40 años a 80 años (Adulto, Adulto Mayor)

Acepta Voluntarios Saludables

No

Géneros elegibles para el estudio

Todos

Descripción

Inclusion Criteria:

  1. Written informed consent must be obtained before any assessment is performed.
  2. Male and female patients aged 40 - 80 years (inclusive).
  3. Diagnosis of knee osteoarthritis
  4. Radiographic evidence of tibiofemoral compartment osteoarthritis
  5. Pain in the knee during the last 24 hours.The patients should also have had pain in the affected knee on most days over the last month.
  6. Patients who are willing to discontinue all non-steroidal anti-inflammatory drugs (NSAIDs) or other analgesic medication taken for any condition, including their knee pain,
  7. Patients who are on stable dose of opioids for at least 1 month before screening can continue to take their opioid at this stable dose throughout the study.
  8. Patients must also be willing to abstain from any intra-articular or peri-articular injections to the knee or surgery during the treatment period
  9. Patients who, if they are currently taking aspirin (325 mg/day or less; as anti-coagulants), are willing to remain on a stable dose one month prior to screening and throughout the study

Exclusion Criteria:

  1. Subjects with known hypersensitivity to any biological or investigational drugs.
  2. Patients with contraindications to knee injections
  3. Patients with joint effusion
  4. Patients should not have rheumatoid arthritis or any connective tissue like disease
  5. Secondary osteoarthritis with history and/or any evidence of the following diseases: septic arthritis, inflammatory joint disease, gout, Paget's disease of the bone, articular fracture, major dysplasias or congenital abnormality, ochronosis, acromegaly, hemochromatosis, Wilson's disease, primary osteochondromatosis, juvenile chronic arthritis with continued activity in adulthood, heritable disorders (e.g. hypermobility). Patients with secondary osteoarthritis following menisectomy or injuries of a collateral or cruciate ligament are not excluded.
  6. Presence or history of underlying metabolic, endocrine, hematologic, pulmonary, cardiac, blood, renal, hepatic, infectious, psychiatric or gastrointestinal conditions
  7. Evidence of tuberculosis (TB)
  8. One of the risk factors for TB such as:

    1. Substance abuse (e.g. injection or non-injection)
    2. Health-care workers with unprotected exposure to patients who are at high risk of TB
    3. Patients with TB disease before the identification and correct airborne precautions of the patient
    4. close contact (i.e. share the same air space in a household or other enclosed environment for a prolonged period (days or weeks, not minutes or hours)) with a person with active pulmonary TB disease.
  9. Significant medical problems, including but not limited to the following: uncontrolled hypertension,congestive heart failure, uncontrolled diabetes type I and II
  10. Subjects with evidence of hepatic or blood coagulation disorders (i.e. hemophilia, etc), anemia, idiopathic thrombocytopenic purpura, or gastrointestinal disorder: severe hepatic disease, history of alcohol and drug abuse; disease of gall bladder and pancreas; active peptic ulceration, gastrointestinal bleeding or history of severe gastro-esophageal reflux disease or severe hiatus hernia; inflammatory bowel disease.
  11. Use of any therapeutic protein drug (e.g. anti-tumor necrosis factor alpha (TNFα) antibody)
  12. Presence of severe renal function impairment. History of renal trauma, glomerulonephritis, patients with one kidney, or renal failure requiring regular dialysis treatment.
  13. Pregnant or nursing (lactating) women, where pregnancy is defined as the state of a female after conception and until the termination of gestation, confirmed by a positive pregnancy test (serum or urine).
  14. Subjects with known contra-indications to naproxen (e.g. heart or circulation problems, history of ulcer disease etc.), analgesics, antipyretics, or NSAIDs.
  15. Disease of the spine or other lower extremity joints which may interfere with the assessment of the target joint.
  16. Surgery on the knee within the last year. Observational arthroscopy, arthroscopic surgery or lavage of the knee within the last 6 months.
  17. Use of assistive devices other than a cane (walking stick) or knee brace.
  18. Subjects who have experienced, any time in the past, asthma, acute rhinitis, nasal polyps, angioneurotic edema, urticaria or other allergic-type reaction after taking acetylsalicylic acid (ASA)/ aspirin or NSAIDs.
  19. Any history of prior peptic ulcer disease or prior NSAID gastrointestinal complications for the past 5 years.

Other protocol defined inclusion/exclusion criteria may apply.

Plan de estudios

Esta sección proporciona detalles del plan de estudio, incluido cómo está diseñado el estudio y qué mide el estudio.

¿Cómo está diseñado el estudio?

Detalles de diseño

  • Propósito principal: Tratamiento
  • Asignación: Aleatorizado
  • Modelo Intervencionista: Asignación paralela
  • Enmascaramiento: Triple

Armas e Intervenciones

Grupo de participantes/brazo
Intervención / Tratamiento
Experimental: Part A: Canakinumab
In this ascending dose part, participants received a single intra-articular injection of canakinumab. The beginning dose was 150 mg, escalating to the 300 mg dose and then to 600 mg.
Intra-articular injection
Otros nombres:
  • ACZ885
Comparador de placebos: Part A: Placebo
Participants received a single intra-articular injection of canakinumab-matching placebo.
Intra-articular injection
Experimental: Part B: Canakinumab
Participants received a single intra-articular injection of canakinumab on Day 1 and naproxen matching placebo tablets orally twice daily for 12 weeks.
Intra-articular injection
Otros nombres:
  • ACZ885
Tablets for oral administration
Comparador de placebos: Part B: Placebo
Participants received a single intra-articular injection of canakinumab matching placebo on Day 1 and naproxen matching placebo tablets orally twice daily for 12 weeks.
Intra-articular injection
Tablets for oral administration
Comparador activo: Part B: Naproxen
Participants received a single intra-articular injection of canakinumab matching placebo on Day 1 and naproxen 500mg tablets orally twice daily for 12 weeks.
Intra-articular injection
Tablets for oral administration

¿Qué mide el estudio?

Medidas de resultado primarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Part A: Number of Participants With Intolerance Events
Periodo de tiempo: Baseline to Day 3
An intolerance event is defined as an acute inflammatory reaction, characterized by a 30 mm increase in pain (on a 100 mm visual analog scale (VAS) and associated with a new or worsened synovial fluid effusion within 3 days following the intra-articular (i.a.) injection. If baseline VAS pain score is ≥ 70 mm, an intolerance event is defined as an increase in pain by 20 mm on a 100 mm VAS associated with new or worsened synovial fluid effusion within 3 days following the i.a. injection. If baseline VAS pain score is ≥ 80 mm, an intolerance event is defined as an increase in pain by 10 mm on a 100 mm VAS associated with new or worsened synovial fluid effusion within 3 days following the i.a. injection. If baseline pain score is ≥ 90 mm, an intolerance event is defined as the patients experiencing an unspecified increase in pain on a 100 mm VAS associated with new or worsened synovial fluid effusion within 3 days following the i.a. injection.
Baseline to Day 3
Part B: Change From Baseline to Day 4 in Pain Using 100 mm Visual Analog Scale (VAS)
Periodo de tiempo: Baseline and Day 4

After walking for 20 meters, participants were asked to assess the pain in their affected knee on a 100 mm linear visual analog scale ranging from no pain (0 mm) to unbearable pain (100 mm). A negative change from Baseline score indicates improvement.

Results are from a Bayesian analysis of covariance (ANCOVA) model, fitting baseline pain VAS score as a covariate, time by treatment as fixed effects, region and subject as random effects.

Baseline and Day 4
Part B: Change From Baseline to Week 4 in Western Ontario and McMaster Osteoarthritis Index (WOMAC) Pain Subscale
Periodo de tiempo: Baseline and Week 4

The Western Ontario and McMaster osteoarthritis Index (WOMAC) pain subscale asks patients to rate pain in the index knee joint in the last 48 hours doing different activities on a scale from none (0) to extreme pain (4). The answers are summed and the total pain subscale score ranges from 0 to 20, where higher scores indicate more pain. A negative change from Baseline score indicates improvement.

Results are from a Bayesian ANCOVA model, fitting baseline WOMAC pain score as a covariate, time by treatment as fixed effects, region and patient as random effects.

Baseline and Week 4

Medidas de resultado secundarias

Medida de resultado
Medida Descripción
Periodo de tiempo
Part B: Change From Baseline in Pain Using 100 mm Visual Analog Scale (VAS)
Periodo de tiempo: Baseline and Weeks 4, 8 and 12

After walking for 20 meters, participants were asked to assess the pain in their affected knee on a 100 mm linear visual analog scale ranging from no pain (0 mm) to unbearable pain (100 mm).

Results are from a Bayesian ANCOVA model, fitting baseline pain VAS score as a covariate, time by treatment as fixed effects, region and patient as random effects.

Baseline and Weeks 4, 8 and 12
Part B: Percentage of Responders in the Pain 100 mm Visual Analog Scale (VAS)
Periodo de tiempo: Baseline, Day 4, Weeks 1, 2, 4, 8 and 12
A responder is defined as a participant with a 50% or greater reduction from baseline on the VAS scale for pain assessment. After walking for 20 meters, participants were asked to assess the pain in their affected knee on a 100 mm linear visual analog scale ranging from no pain (0 mm) to unbearable pain (100 mm).
Baseline, Day 4, Weeks 1, 2, 4, 8 and 12
Part B: Change From Baseline in WOMAC Pain, Stiffness and Physical Function Subscales
Periodo de tiempo: Baseline and Weeks 4, 8 and 12

The WOMAC consists of 3 subscales:

The Pain subscale asks patients to rate pain in the index knee joint in the last 48 hours during walking, using stairs, in bed, sitting or lying, and standing on a scale from none (0) to extreme pain (4). The answers are summed and the total pain subscale score ranges from 0-20.

The Stiffness subscale assesses stiffness in the index knee joint during the last 48 hours doing different activities on a scale from none (0) to extreme stiffness (4). The total stiffness subscale score ranges from 0-8.

The Physical Function subscale assesses difficulty performing daily physical activities during the last 48 hours on a scale from none (0) to extreme difficulty (4). The total physical function subscale score ranges from 0-68.

Higher scores indicate more pain/stiffness/difficulty. Results are from a Bayesian ANCOVA model, with baseline WOMAC score as a covariate, time by treatment as fixed effects, region and patient as random effects.

Baseline and Weeks 4, 8 and 12
Part B: Proportion of Participants Who Used Rescue Analgesic During Study
Periodo de tiempo: Day 4, Weeks 1, 2, 4, 8 and 12
Participants were permitted to take oral rescue medication (Acetaminophen ≤ 4 gram/day) up until 24 hours of a scheduled assessment visit during the 12-week treatment period. The estimates shown are the Kaplan-Meier estimates of the proportion of participants that took rescue medication.
Day 4, Weeks 1, 2, 4, 8 and 12
Patient's Global Assessment of Response to Treatment on Day 4
Periodo de tiempo: Day 4
Participants made a global assessment of their response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Poor, Very Poor.
Day 4
Patient's Global Assessment of Response to Treatment at Week 2
Periodo de tiempo: Week 2
Participants made a global assessment of their response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Poor, Very Poor.
Week 2
Patient's Global Assessment of Response to Treatment at Week 4
Periodo de tiempo: Week 4
Participants made a global assessment of their response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Poor, Very Poor.
Week 4
Patient's Global Assessment of Response to Treatment at Week 8
Periodo de tiempo: Week 8
Participants made a global assessment of their response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Poor, Very Poor.
Week 8
Patient's Global Assessment of Response to Treatment at Week 12
Periodo de tiempo: Week 12
Participants made a global assessment of their response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Poor, Very Poor.
Week 12
Part B: Physician's Global Assessment of Response to Treatment at Day 4
Periodo de tiempo: Day 4
The study physician made a global assessment of response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Poor, Very Poor.
Day 4
Part B: Physician's Global Assessment of Response to Treatment at Week 2
Periodo de tiempo: Week 2
The study physician made a global assessment of response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Poor, Very Poor.
Week 2
Part B: Physician's Global Assessment of Response to Treatment at Week 4
Periodo de tiempo: Week 4
The study physician made a global assessment of response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Poor, Very Poor.
Week 4
Part B: Physician's Global Assessment of Response to Treatment at Week 8
Periodo de tiempo: Week 8
The study physician made a global assessment of response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Poor, Very Poor.
Week 8
Part B: Physician's Global Assessment of Response to Treatment at Week 12
Periodo de tiempo: Week 12
The study physician made a global assessment of response to treatment using a 5-point Likert scale: Excellent, Good, Acceptable, Poor, Very Poor.
Week 12
Maximum Observed Plasma Concentration of Canakinumab (Cmax)
Periodo de tiempo: Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Time to Reach the Maximum Observed Plasma Concentration of Canakinumab (Tmax)
Periodo de tiempo: Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Area Under the Concentration Time Curve up to the Last Measurable Concentration (AUClast)
Periodo de tiempo: Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Area Under the Concentration Time Curve From Time Zero to Infinity AUC(0-inf)
Periodo de tiempo: Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Terminal Phase Half-life (t1/2) of Canakinumab
Periodo de tiempo: Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
The time it takes for the concentration level of canakinumab to fall to 50% of the original value.
Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Apparent Clearance of Canakinumab From Plasma (CL/F)
Periodo de tiempo: Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Apparent Volume of Distribution During Terminal Phase (Vz/F)
Periodo de tiempo: Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.
Day 1, pre-dose and 1, 3, 6 and 8 hours post-dose (Part A only), Day 2, 4, 8, 15, 29, 57, 85 and 126.

Colaboradores e Investigadores

Aquí es donde encontrará personas y organizaciones involucradas en este estudio.

Fechas de registro del estudio

Estas fechas rastrean el progreso del registro del estudio y los envíos de resultados resumidos a ClinicalTrials.gov. Los registros del estudio y los resultados informados son revisados ​​por la Biblioteca Nacional de Medicina (NLM) para asegurarse de que cumplan con los estándares de control de calidad específicos antes de publicarlos en el sitio web público.

Fechas importantes del estudio

Inicio del estudio

1 de abril de 2010

Finalización primaria (Actual)

1 de julio de 2011

Finalización del estudio (Actual)

1 de julio de 2011

Fechas de registro del estudio

Enviado por primera vez

9 de julio de 2010

Primero enviado que cumplió con los criterios de control de calidad

9 de julio de 2010

Publicado por primera vez (Estimar)

12 de julio de 2010

Actualizaciones de registros de estudio

Última actualización publicada (Estimar)

30 de octubre de 2012

Última actualización enviada que cumplió con los criterios de control de calidad

28 de septiembre de 2012

Última verificación

1 de septiembre de 2012

Más información

Esta información se obtuvo directamente del sitio web clinicaltrials.gov sin cambios. Si tiene alguna solicitud para cambiar, eliminar o actualizar los detalles de su estudio, comuníquese con register@clinicaltrials.gov. Tan pronto como se implemente un cambio en clinicaltrials.gov, también se actualizará automáticamente en nuestro sitio web. .

Ensayos clínicos sobre Canakinumab

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