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Study of AS902330 (rhFGF-18) Administered Intra-articularly in Patients With Knee Primary Osteoarthritis Who Are Candidates for Total Knee Replacement

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Read our disclaimer for details. Identifier: NCT00911469
Recruitment Status : Completed
First Posted : June 2, 2009
Last Update Posted : August 5, 2014
Merck Serono S.A., Geneva
Information provided by (Responsible Party):
Merck KGaA, Darmstadt, Germany

Brief Summary:

Osteoarthritis (OA) is one of the most common diseases affecting the joints, usually those that are weight bearing such as the knees. OA is considered to be a disease of the cartilage in the joints even though it involves the whole joint, including the bone and synovium (thin lining of the joints which produces synovial fluid). With time, more and more of the cartilage is destroyed by the disease with inflammation commonly occurring.

AS902330 is expected to increase the production and development of specific bone cells: chondrocytes and osteoblasts (cells that produce and maintain bone and cartilage). This is expected to lead to repair and regeneration of the cartilage, and a narrowing of the space width between the knee joints in a selected region of the knee.The purpose of this study is to see how safe treatment with AS902330 is, and to evaluate its effect on the knee cartilage. In addition, the study will also measure the effects of AS902330 in the blood.

Condition or disease Intervention/treatment Phase
Knee Osteoarthritis Drug: AS902330 Drug: Placebo Phase 1

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Study Type : Interventional  (Clinical Trial)
Actual Enrollment : 73 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Randomised, Double-blind, Placebo-controlled, Multicentre, Single and Multiple Ascending Dose Study of AS902330 (rhFGF-18) Administered Intra-articularly in Patients With Knee Primary Osteoarthritis Who Are Candidates for Total Knee Replacement.
Study Start Date : November 2007
Actual Primary Completion Date : April 2010
Actual Study Completion Date : June 2010

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Osteoarthritis

Arm Intervention/treatment
Experimental: 1 Drug: AS902330
3, 10, 30, 100 or 300 µg intra-articular injection per subject in the Single Ascending Dose (SAD) cohorts and 10, 30, 100, 300 µg or highest tolerated dose intra-articular injection per week for three weeks per subject in the Multiple Ascending Dose (MAD) cohorts.

Placebo Comparator: 2 Drug: Placebo
Placebo or, 3, 10, 30, 100 or 300 µg intra-articular injection per subject in SAD cohorts and placebo or, 10, 30, 100, 300 µg or highest tolerated dose of AS902330 intra-articular injection per week for three weeks per subject in MAD cohorts.

Primary Outcome Measures :
  1. Nature, incidence and severity of treatment-emergent adverse events (TEAEs) [ Time Frame: Up to 24 weeks post treatment ]
  2. Proportion of subjects with predefined local AEs (acute inflammatory reactions defined as increase of pain by 30 mm - on a 100 mm VAS - associated with a self-reported synovial fluid effusion within 3 days following i.a. injection) [ Time Frame: Up to 24 weeks post treatment ]
  3. Local tolerability in the target knee [ Time Frame: Up to 24 weeks post treatment ]
  4. Laboratory safety parameters (including blood chemistry, haematology, and urinalysis) and ECG [ Time Frame: Up to 24 weeks post treatment ]

Secondary Outcome Measures :
  1. Change over time in the levels of the following biomarkers: Biomarkers of anabolic effect on knee cartilage (markers of cartilage formation/synthesis) [ Time Frame: Up to 24 weeks post treatment ]
  2. Change over time in the levels of the following biomarkers: Biomarkers of catabolic effect on knee cartilage (markers of cartilage degradation) [ Time Frame: Up to 24 weeks post treatment ]
  3. Change over time in the levels of the following biomarkers: Biomarkers of Bone Metabolism [ Time Frame: Up to 24 weeks post treatment ]
  4. Change in levels of cytokines related to inflammation (IL1b, IL6, IL8, TNFα and IFNα) [ Time Frame: Up to 24 weeks post treatment ]
  5. Blood levels of AS902330 [ Time Frame: Up to 24 weeks post treatment ]
  6. Presence of anti-AS902330 antibodies [ Time Frame: Up to 24 weeks post treatment ]

Information from the National Library of Medicine

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Ages Eligible for Study:   40 Years and older   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No

Inclusion Criteria:

  1. Established diagnosis of knee primary femoro-tibial OA by standard American College of Rheumatology Criteria (ACR) for at least six months (clinical AND radiological criteria)
  2. Postmenopausal or surgically sterile female ≥ 40 years of age Post-menopausal status will be confirmed by no menstrual periods for 12 consecutive months and no other biological or physiological cause for amenorrhea can be identified or Male ≥ 40 years of age willing to use contraception (condom with spermicide) from the first day of treatment until 2 months after the end of the treatment (3rd injection in Period 2) Even though systemic exposure of the drug is not foreseen at the doses used in this study, due to the absence of data on teratogenic potential of the drug, a very conservative approach on contraception is taken based on the spermatogenesis duration in humans.
  3. Candidate for Total Knee Replacement in the target knee, according to NIH consensus statement on Total Knee Replacement (2003)
  4. Date of planned Total Knee Replacement in the target knee ≥ 2 weeks after the anticipated last injection of study drug
  5. Subjects may be on treatment for symptomatic relief of OA, including NSAIDs (including Cox2 specific inhibitors); for NSAIDs, the dose should be stable for 4 weeks before baseline and during the study until day 4 after last injection. Paracetamol/acetaminophen (according to local standards and up to 4 grams per day) is allowed as rescue medication
  6. Willingness to stay in hospital for 24h after injection for SAD regimens and after first injection for MAD regimens (and up to 4 hours after second and third injections for MAD regimens) for safety and PK evaluation
  7. Willingness to complete a diary card to evaluate local tolerability and adverse events throughout the study
  8. Subjects must have read and understood the informed consent form and must have signed it prior to any study related procedure
  9. Subjects must fully understand the requirements of the study and be willing to comply with all study visits and assessments

Exclusion Criteria:

  1. Any 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
  2. Clinically significant abnormal hematology or biochemistry values (platelets, hemoglobin, leucocytes, alkaline phosphatase, AST, ALT, blood creatinine, bilirubin)
  3. Receipt of any investigational product or any experimental therapeutic procedure within the last 12 weeks preceding screening
  4. Intra-articular treatment with steroids or hyaluronic acid derivatives within the past 3 months (systemic symptomatic treatments with NSAIDs are allowed when stable for 4 weeks prior to first injection)
  5. Planned major surgery (e.g. joint replacement) within 2 weeks after last injection
  6. History of previous surgery (TKR or partial knee replacement) on the target knee
  7. Lesions at the planned injection site that would present a contra-indication to local injection of the study drug (e.g., open wounds and infections of the skin)Any drug or nutraceutical treatment with potential DMOAD effect (glucosamine, diacerin, chondroitin sulfate) unless given at a stable dose over at least 4 weeks prior to first injection
  8. Use of electrotherapy or acupuncture for OA
  9. Any known active infections, including suspicion of intra-articular infection and/or infections that may compromise the immune system such as HIV, Hepatitis B or Hepatitis C infection
  10. History of sarcoma and/or history of other active malignancy within five years, except adequately treated basal cell and squamous cell carcinoma of the skin
  11. Signs and symptoms suggestive of transmissible spongiform encephalopathy
  12. Secondary osteoarthritis: e.g. Joint dysplasias, Aseptic osteonecrosis, Acromegaly, Paget's disease, Ehlers-Danlos Syndrome, Gaucher's disease, Stickler's syndrome, Joint infection, Hemophilia, Hemochromatosis, Calcium Pyrophosphate deposition disease, or Neuropathic arthropathy whatever the cause Patients with risk factors for knee OA (e.g. obesity, meniscectomy) are not considered as having secondary OA and can be included in this study.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT00911469

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UMHAT "Sv. Ivan Rilski", Clinical Research Unit for Phase I
Sofia, Bulgaria
Frederiksberg Hospital
Frederiksberg, Denmark
Gentofte Hospital
Hellerup, Denmark
Nordsjællands Hospital - Hørsholm
Hørsholm, Denmark
Silkeborg sygehus
Silkeborg, Denmark
Regionshospitalet Viborg
Viborg, Denmark
Kuopio University Hospital
Kuopio, Finland
Oulu University Hospital
Oulu, Finland
Turku University Central Hospital
Turku, Finland
South Africa
FARMOVS-PAREXEL (Pty) Ltd, University of the Free State
Bloemfontein, South Africa
George, South Africa
PAREXEL-Port Elizabeth, Mercantile Hospital
Port Elizabeth, South Africa
Sahlgrenska University Hospital/Östra
Göteborg, Sweden
Hässleholms Sjukhus
Hässleholm, Sweden
Kungälv Sjukhus
Kungälv, Sweden
Lund University Hospital
Lund, Sweden
Malmö University Hospital
Malmö, Sweden
Danderyds Sjukhus
Stockholm, Sweden
United Kingdom
Cambridge University Hospitals
Cambridge, United Kingdom
Sponsors and Collaborators
Merck KGaA, Darmstadt, Germany
Merck Serono S.A., Geneva
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Study Director: Donatus Dreher, MD, PhD Merck Serono SA - Geneva

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Responsible Party: Merck KGaA, Darmstadt, Germany Identifier: NCT00911469     History of Changes
Other Study ID Numbers: 27575
First Posted: June 2, 2009    Key Record Dates
Last Update Posted: August 5, 2014
Last Verified: August 2014

Keywords provided by Merck KGaA, Darmstadt, Germany:
Knee osteoarthritis
fibroblast growth factor 18

Additional relevant MeSH terms:
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Osteoarthritis, Knee
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases