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- Klinische proef NCT07225829
Een onderzoek naar de veiligheid en werkzaamheid van intra-articulaire 4P004-injectie bij proefpersonen met knie-synovitis en artrose (INFLAM MOTION)
Een multicenter, gerandomiseerd, dubbelblind, placebo-gecontroleerd, proof of concept onderzoek naar de werkzaamheid en veiligheid van intra-articulair 4P004 bij proefpersonen met knie-synovitis en artrose
This phase 2a trial is an international, multicenter, randomized, double-blind, placebo-controlled trial to investigate the efficacy and safety of one single intra-articular (IA) injection of 4P004 or placebo in:
- patients between 40 and 80 years of age,
- with synovitis and grade 2 to 4 osteoarthritis (OA) of the knee according to Kellgren and Lawrence (KL) classification.
Studie Overzicht
Toestand
Conditie
Interventie / Behandeling
Studietype
Inschrijving (Werkelijk)
Fase
- Fase 2
Contacten en locaties
Studie Locaties
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Ajax, Canada
- Durham Bone and Joint Specialists
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London, Canada
- SJHC London Rheumatology Centre
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Québec, Canada
- G.R.M.O. (Groupe de recherche en maladies osseuses) Inc
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Frederiksberg, Denemarken
- Parker Institute Bispebjerg, Frederiksberg Hospital
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Herlev, Denemarken
- Sanos Clinic Herlev
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Montpellier, Frankrijk
- CHU Montpellier
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Nice, Frankrijk
- ChU de Nice
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Paris, Frankrijk
- Hôpital Lariboisière
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Paris, Frankrijk
- Hôpital Cochin
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Reims, Frankrijk
- Centre Hospitalier Universitaire CHU de Reims - Hopital Maison Blanche
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Krakow, Polen
- Care Access Kraków
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Warsaw, Polen
- Centrum Medyczne Reuma Park
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Warsaw, Polen
- MICS Centrum Medyczne Warszawa
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A Coruña, Spanje
- Complejo Hospitalario Universitario de A Coruna - Hospital Universitario de A Coruna
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A Coruña, Spanje, 15702
- Clínica Gaias Santiago
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Alicante, Spanje
- HLA Clínica Vistahermosa
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Sabadell, Spanje
- Corporacio Sanitaria Parc Tauli - Hospital de Sabadell
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Santiago de Compostela, Spanje
- Clinica Nuestra Senora de la Esperanza
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Seville, Spanje
- Hospital Quirónsalud Sagrado Corazón
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Arizona
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Tucson, Arizona, Verenigde Staten, 85712-2805
- Tucson Orthopaedic Institute
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Illinois
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Chicago, Illinois, Verenigde Staten, 60611
- Northwestern University Feinberg School of Medicine
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Massachusetts
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Burlington, Massachusetts, Verenigde Staten, 01803
- Skylight Health Research Burlington
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
Accepteert gezonde vrijwilligers
Geslachten die in aanmerking komen voor studie
Beschrijving
Inclusion Criteria:
- Participants who have the capacity to give informed consent and who are willing to comply with all trial related procedures and assessments.
- Participants between 40 and 80 years of age.
- Female participant of childbearing potential (defined as any woman unless postmenopausal for at least one year or surgically sterile) must use highly effective methods of contraception as defined in the protocol. Highly effective contraceptive measures must be continued throughout the trial until the final visit.
- Bodyweight > 40 kg.
- Body mass index (BMI) ≥ 18.5 and ≤ 35.
- Ambulatory (single assistive devices such as canes allowed).
- Widespread Pain Index (WPI) ≤ 4.
- Pain NRS (0-10) < 4 in the contralateral knee.
- History of OA-related pain of the TK for at least 6 months.
- Moderate to severe pain of the TK the majority of days during the last 3 months as per participant's judgement.
- Moderate to severe pain of the TK on the WOMAC Pain subscale prior to the Randomization visit (V2) complying with: a) Complete WOMAC Pain diary for at least 7 of the last 10 days prior to V2 (including V2/D1 rating which is mandatory), and b) Diary reported WOMAC Pain between 5 and 9 for at least 7 of the last 10 days.
- History of insufficient pain relief, intolerance, or contraindication to NSAIDs, and at least a history of insufficient pain relief from at least one of the following therapies: a) Acetaminophen/paracetamol, b) Opioids including tramadol, or c) Corticosteroids, hyaluronate IA injections (efficacy less than 3 months according to the patient).
- KL grade 2 to 4 on the Schuss radiograph.
- Predominant femorotibial OA based on the OA Research Society International. (OARSI) Atlas reading (Altman & Gold, 2007).
- Presence of synovitis in the TK assessed locally using PDUS, and synovial thickness of ≥ 5 mm evaluated through a longitudinal view of the suprapatellar pouch and axial views of the medial and lateral patellofemoral pouches.
- Negative urine drug screen (performed locally): amphetamines, barbiturates, cocaine.
- CE-MRI Central reading to confirm synovitis with a synovial Semi-Quantitative (SQ) ≥ 9 or a SQ score ≥7 with at least one site with a score ≥ 2.
Exclusion Criteria:
- Pregnant or breastfeeding women.
- Significant malalignment of anatomical axis (medial angle formed by the femur and tibia) of the TK (varus > 10°, valgus > 10°) by radiography.
- Secondary OA such as joint dysplasia, aseptic osteonecrosis, joint infection, acromegaly, Paget disease, hemochromatosis, joint crystal disease or any inflammatory joint disease.
- Any known active infections including skin infections at the site injection or increased predisposition for the development of infections.
- Any partial knee replacement of the TK.
- Acute fracture or IA trauma to the TK within 12 months prior to the screening visit.
- Major knee surgery performed within the previous 12 months or planned during the trial.
- Arthroscopy of the TK within 6 months prior to the screening visit.
- Presence of any painful conditions that could confound accurate assessment of pain from OA in the TK, such as fibromyalgia, peripheral neuropathy or vascular insufficiency.
- Treatment with systemic corticosteroids (other than IA) at a dose greater than 10 mg prednisone or the equivalent per day for more than 7 days within 4 weeks prior to the screening visit.
- Treatment of the TK with any IA injection (including corticosteroids, hyaluronic acid derivatives, Platelet Rich Plasma….) within 24 weeks prior to the screening visit.
- Any treatment with glucosamine, chondroitin sulfate, or other nutraceuticals with potential activity on OA within the previous 3 months prior to the screening visit.
- Treatment with duloxetine for OA (allowed if given for depressive disorders at stable dose since at least 3 months before V1).
- Any significant psychiatric illness unless well controlled since at least 6 months.
- Current treatment with combination of insulin and liraglutide (Xultophy®) or with GLP-1 agonist administered once a week (semaglutide, dulaglutide).
- High-risk of bleeding.
- Congestive Heart Failure stage III or IV in the New York Heart Association classification.
- History or current diagnosis of electrocardiogram ECG abnormalities indicating significant safety risk (such as ischemia, significant cardiac arrhythmias).
- Glycemia < 4.4 mmol/L (or 80 mg/dL) at screening.
- Clinically significant abnormal laboratory test at screening, in particular: haemoglobin <10 g/dL, white blood cell <3000/µL (3.0 Giga/L), absolute neutrophil count <1000/µL (1.0 Giga/L), platelets count <100,000/µL (100 Giga/L), alanine aminotransferase or aspartate aminotransferase >2.5 upper limit of normal (ULN), total bilirubin >1.5 ULN, lipasemia >1 ULN.
- Estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2, using Chronic Kidney Disease - EPIdemiology (CKD EPI) 2021 Formula.
- Any other abnormal laboratory results that the Investigator believes should preclude the subject's participation in the trial.
- History of hypersensitivity to IMP or excipients (liraglutide or disodium phosphate dihydrate, propylene glycol, phenol).
- Any contraindication for MRI (cardiac pacemaker, deep brain stimulators, intraocular metal, cerebral aneurysm clips, recent stents, cochlear implants, neurostimulators and implantable pumps) or inability to undergo MRI (e.g., body size, leg not fitting in the coil, claustrophobia).
- History of hypersensitivity reactions to a gadolinium-based contrast agent.
- Any CE-MRI Central reading additional diagnoses: posterior meniscal root tears, subchondral insufficiency fractures, osteonecrosis, malignant bone marrow infiltration, solid tumours, and traumatic fracture or bone bruise using ROAMES (Roemer et al., 2020).
- Previous participation in clinical research with a disease-modifying OA drug during the last 2 years.
- Participation in an interventional clinical research trial within 3 months before screening.
- Participants who, in the investigator's judgement, are at risk of falling.
- Participants with a history, or current diagnosis, of pancreatitis, thyroid cancer (including medullary thyroid carcinoma), multiple endocrine neoplasia type-2 (MEN2), diabetic ketoacidosis, type-1 diabetes mellitus (T1DM), inflammatory bowel disease, or diabetic gastroparesis.
- Participants currently, or within the last 10 days, taking any anticoagulant treatment.
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Behandeling
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
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Experimenteel: 4P004 (2mL)
One IA injection in the knee of 4P004 (2mL) on the day of randomization |
Single intra-articular injection in the knee joint
Andere namen:
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Placebo-vergelijker: Placebo (NaCl 0.9% 2mL)
One IA injection in the knee of Placebo (NaCl 0.9% 2mL) on the day of randomization |
Single intra-articular injection in the knee joint |
Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Change from Baseline at Week 4 in the weekly average of Target Knee (TK) daily pain intensity using the WOMAC (Western Ontario and McMaster Universities Arthritis Index) Pain subscore
Tijdsspanne: Baseline and Week 4
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The WOMAC is a questionnaire widely used in the evaluation of knee osteoarthritis. It contains 24 items measuring 3 subscales: physical function (17 items), pain (5 items), and stiffness (2 items). Scores are calculated for each subscale and summed up, with a possible score range of 0-20 for Pain, 0-8 for Stiffness, and 0-68 for Physical Function. The sum of the scores for all three subscales gives a total WOMAC score. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations. |
Baseline and Week 4
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Percentage (%) van OMERACT-OARSI Responders op Week 2, Week 4, Week 8 en Week 12
Tijdsspanne: Week 2, Week 4, Week 8 en Week 12
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Week 2, Week 4, Week 8 en Week 12
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Incidentie en ernst van TEAE's (Treatment-Emergent Adverse Events) tijdens de studie
Tijdsspanne: Van randomisatie tot einde van de studie, tot 12 weken
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Van randomisatie tot einde van de studie, tot 12 weken
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Absolute veranderingen ten opzichte van de uitgangswaarde in klinisch laboratoriumonderzoek - hematologieparameter: totaal aantal bloedcellen (in cel/L)
Tijdsspanne: Van randomisatie tot einde van de studie (tot 12 weken)
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Van randomisatie tot einde van de studie (tot 12 weken)
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Absolute veranderingen ten opzichte van de baseline in klinische laboratoriumbeoordelingen - hematologieparameter: hemoglobine (in g/L)
Tijdsspanne: Van randomisatie tot einde van de studie (tot 12 weken)
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Van randomisatie tot einde van de studie (tot 12 weken)
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Absolute veranderingen ten opzichte van de uitgangswaarde in klinische laboratoriumbeoordeling - bloedchemie: AST (in U/L)
Tijdsspanne: Van randomisatie tot einde van de studie (maximaal 12 weken)
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Van randomisatie tot einde van de studie (maximaal 12 weken)
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Absolute veranderingen ten opzichte van de uitgangswaarde in klinische laboratoriumbeoordeling - bloedchemie: ALT (in U/L)
Tijdsspanne: Van randomisatie tot einde van de studie (tot 12 weken)
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Van randomisatie tot einde van de studie (tot 12 weken)
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Absolute veranderingen ten opzichte van de uitgangswaarde in klinische laboratoriumbeoordeling - bloedchemie: lipase (in U/L)
Tijdsspanne: Van randomisatie tot einde van de studie (maximaal 12 weken)
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Van randomisatie tot einde van de studie (maximaal 12 weken)
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Absolute veranderingen ten opzichte van de uitgangswaarde in klinisch laboratoriumonderzoek - bloedchemie: nuchtere glykemie (in mmol/L)
Tijdsspanne: Van randomisatie tot einde van de studie (maximaal 12 weken)
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Van randomisatie tot einde van de studie (maximaal 12 weken)
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Absolute veranderingen ten opzichte van de baseline in klinisch laboratoriumonderzoek - bloedchemie: totaal bilirubine (in μmol/L)
Tijdsspanne: Van randomisatie tot einde van de studie (tot 12 weken)
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Van randomisatie tot einde van de studie (tot 12 weken)
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Absolute veranderingen ten opzichte van de uitgangswaarde voor vitale functies: systolische en diastolische bloeddruk (BP)
Tijdsspanne: Van randomisatie tot einde van de studie (tot 12 weken)
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Van randomisatie tot einde van de studie (tot 12 weken)
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Absolute veranderingen ten opzichte van de uitgangswaarde bij vitale functies: polssnelheid
Tijdsspanne: Van randomisatie tot einde van de proef (maximaal 12 weken)
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Van randomisatie tot einde van de proef (maximaal 12 weken)
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Change from Baseline at Week 2, Week 6, Week 8, Week 10 and Week 12 in the weekly average of TK (Target Knee) daily pain intensity using the WOMAC (Western Ontario and McMaster Universities Arthritis Index) Pain subscore
Tijdsspanne: Baseline, Week 2, Week 6, Week 8, Week 10 and Week 12
|
The WOMAC is a questionnaire widely used in the evaluation of knee osteoarthritis. It contains 24 items measuring 3 subscales: physical function (17 items), pain (5 items), and stiffness (2 items). Scores are calculated for each subscale and summed up, with a possible score range of 0-20 for Pain, 0-8 for Stiffness, and 0-68 for Physical Function. The sum of the scores for all three subscales gives a total WOMAC score. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations. |
Baseline, Week 2, Week 6, Week 8, Week 10 and Week 12
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Change from Baseline at Week 2, Week 4, Week 8 and Week 12 in the NRS (Numeric Rating Scale) pain (scale 0-10) in a nominated pain aggravating activity
Tijdsspanne: Baseline, Week 2, Week 4, Week 8 and Week 12
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The numeric rating scale (NRS) is a pain screening tool, commonly used to assess pain severity at that moment in time, using a 0-10 scale, with zero meaning "no pain" and 10 meaning "the worst pain imaginable. |
Baseline, Week 2, Week 4, Week 8 and Week 12
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Change from Baseline at Week 2, Week 4, Week 8 and Week 12 in WOMAC (Western Ontario and McMaster Universities Arthritis Index) subscores and total score
Tijdsspanne: Baseline, Week 2, Week 4, Week 8 and Week 12
|
The WOMAC is a questionnaire widely used in the evaluation of knee osteoarthritis. It contains 24 items measuring 3 subscales: physical function (17 items), pain (5 items), and stiffness (2 items). Scores are calculated for each subscale and summed up, with a possible score range of 0-20 for Pain, 0-8 for Stiffness, and 0-68 for Physical Function. The sum of the scores for all three subscales gives a total WOMAC score. Higher scores on the WOMAC indicate worse pain, stiffness, and functional limitations. |
Baseline, Week 2, Week 4, Week 8 and Week 12
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Change from Baseline at Week 2, Week 4, Week 8 and Week 12 in the Patient Global Assessment of Osteoarthritis (PGA-OA)
Tijdsspanne: Baseline, Week 2, Week 4, Week 8 and Week 12
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The PGA-OA is a 1-item questionnaire designed to assess the participant's impression of disease severity adapted from Guy et al., 1976, to the specific disease as a Patient-reported Outcome measurement "Considering all the ways your knee osteoarthritis affects you, how are you doing these last seven days ?". PGA-OA is measured on a 5-point Likert scale, with higher scores indicating worse symptoms (1= "very good" to 5 = "very poor"). |
Baseline, Week 2, Week 4, Week 8 and Week 12
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Medewerkers en onderzoekers
Sponsor
Onderzoekers
- Studie stoel: Francis Berenbaum, MD, PhD, 4
Studie record data
Bestudeer belangrijke data
Studie start (Werkelijk)
Primaire voltooiing (Werkelijk)
Studie voltooiing (Werkelijk)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
Laatste update geplaatst (Werkelijk)
Laatste update ingediend die voldeed aan QC-criteria
Laatst geverifieerd
Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
- Musculoskeletale aandoeningen
- Artritis
- Gewrichtsziekten
- Reumatische aandoeningen
- Artrose
- Artrose, knie
- Hormonen
- Hormonen, hormoonvervangers en hormoonantagonisten
- Anorganische chemicaliën
- Chloorverbindingen
- Natriumverbindingen
- Gastro -intestinale hormonen
- Glucagon-achtige peptiden
- Proglucagon
- Chloriden
- Zoutzuur
- Glucagon-achtig peptide 1
- Liraglutide
- Natriumchloride
Andere studie-ID-nummers
- 4MB-4P004-P-INFLAM
- 2024-518916-38-00 (Ctis)
Plan Individuele Deelnemersgegevens (IPD)
Bent u van plan om gegevens van individuele deelnemers (IPD) te delen?
Informatie over medicijnen en apparaten, studiedocumenten
Bestudeert een door de Amerikaanse FDA gereguleerd geneesmiddel
Bestudeert een door de Amerikaanse FDA gereguleerd apparaatproduct
product vervaardigd in en geëxporteerd uit de V.S.
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