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Study to Evaluate the Efficacy and Safety of FX006 in Patients With Glenohumeral Osteoarthritis or Shoulder Adhesive Capsulitis

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ClinicalTrials.gov Identifier: NCT04160091
Recruitment Status : Recruiting
First Posted : November 12, 2019
Last Update Posted : March 20, 2020
Sponsor:
Collaborator:
Medpace, Inc.
Information provided by (Responsible Party):
Flexion Therapeutics, Inc.

Brief Summary:
This is a double-blind study to evaluate the efficacy and safety of FX006 in patients with glenohumeral osteoarthritis (OA) or shoulder adhesive capsulitis (AC).

Condition or disease Intervention/treatment Phase
Osteoarthritis of the Shoulder Adhesive Capsulitis Drug: FX006 Drug: Normal Saline Phase 2

Detailed Description:
This is a Phase 2, multicenter, randomized, double-blind, placebo-controlled, parallel-group study in separate cohorts of patients with a documented history of either glenohumeral OA or shoulder AC. Glenohumeral OA and shoulder AC patients will be randomized to receive a single intra-articular injection of either FX006 or placebo (saline) in a 1:1 ratio to the index shoulder with a 24-week Treatment Evaluation Period. Glenohumeral OA patients will be stratified by Baseline average daily shoulder pain with movement score according to the following classifications: 5.0 to <7.0 or ≥7.0 to 9.0 (0 to 10 numeric rating scale [NRS]). Shoulder AC patients will be stratified by Baseline average daily shoulder pain with movement score according to the following classifications: 5.0 to <7.0 or ≥7.0 to 9.0 (0 to 10 NRS), and by pain duration since onset (1 to 3 months, inclusive, or >3 to ≤6 months). A Home Exercise Program will be implemented 3 days following injection for shoulder AC patients.

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Study Type : Interventional  (Clinical Trial)
Estimated Enrollment : 250 participants
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor)
Primary Purpose: Treatment
Official Title: A Phase 2, Randomized, Double-Blind, Placebo-Controlled, Parallel-Group Study to Evaluate the Efficacy and Safety of FX006 in Patients With Glenohumeral Osteoarthritis or Shoulder Adhesive Capsulitis (RANGE)
Actual Study Start Date : November 7, 2019
Estimated Primary Completion Date : October 16, 2020
Estimated Study Completion Date : February 26, 2021

Resource links provided by the National Library of Medicine

MedlinePlus related topics: Osteoarthritis

Arm Intervention/treatment
Experimental: FX006 32mg in Glenohumeral OA Population
Single intra-articular (IA) injection
Drug: FX006
Single intra-articular injection
Other Name: Zilretta

Placebo Comparator: Normal Saline in Glenohumeral OA Population
Single intra-articular (IA) injection
Drug: Normal Saline
Single intra-articular injection

Experimental: FX006 32mg in Adhesive Capsulitis Population
Single intra-articular (IA) injection
Drug: FX006
Single intra-articular injection
Other Name: Zilretta

Placebo Comparator: Normal Saline in Adhesive Capsulitis Population
Single intra-articular (IA) injection
Drug: Normal Saline
Single intra-articular injection




Primary Outcome Measures :
  1. Overall Change in Daily Shoulder Pain with Movement [ Time Frame: Baseline to 8 weeks ]
    The pain intensity score is measured using an 11-point numeric rating scale (NRS), where 0 indicates "No pain" and 10 indicates "Worst possible pain."


Secondary Outcome Measures :
  1. Efficacy of FX006 on Shoulder Pain with Movement [ Time Frame: Baseline to 12 weeks ]
    The pain intensity score is measured using an 11-point numeric rating scale (NRS), where 0 indicates "No pain" and 10 indicates "Worst possible pain."

  2. Efficacy of FX006 on Shoulder Pain [ Time Frame: Baseline to 12 weeks ]
    Shoulder Pain and Disability Index (SPADI) Pain scale is measured using 5 11-point NRS questions where 0 indicates "no pain" and 10 indicates "worst pain imaginable."

  3. Efficacy of FX006 on Shoulder Function [ Time Frame: Baseline to 12 weeks ]
    Shoulder Pain and Disability Index (SPADI) Disability scale is measured using 8 11-point NRS questions where 0 indicates "no difficulty" and 10 indicates "so difficult it requires help."

  4. Efficacy of FX006 on Patient Global Impression of Change (PGIC) [ Time Frame: Baseline to 12 weeks ]
    PGIC is measured using a 7-point NRS where 1 indicates "very much improved" and 7 indicates "very much worse."

  5. Efficacy of FX006 on Range of Motion (ROM) of External Rotation at Week 12 [ Time Frame: Baseline to 12 weeks ]
    Measured using a goniometer which is a device that measures ROM joint angles



Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.


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Ages Eligible for Study:   35 Years to 80 Years   (Adult, Older Adult)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

Glenohumeral OA:

  • Male or female, 35 to 80 years of age, inclusive, on the day of consent.
  • Painful symptoms associated with OA of the index glenohumeral joint for ≤3 months prior to the Screening Visit.
  • Grade 2 or 3 OA in the index glenohumeral joint based on the Samilson-Prieto classification system as confirmed by X-ray (axillary view and true anterior-posterior view) taken at the Screening Visit.

Shoulder AC:

  • Male or female, 35 to 80 years of age, inclusive, on the day of consent.
  • Pain associated with AC of the index joint for ≥1 month but ≤ 6 months prior to the Screening Visit.
  • Limitations on both active and passive ROM ≥25% in at least 2 directions (e.g., forward flexion, abduction, and internal and external rotation assessed in a standardized protocol) compared with the contralateral shoulder or with normal values.
  • No X-ray evidence of OA of the index shoulder (axillary view and true anterior-posterior view) at the Screening Visit.
  • Agrees to complete a standardized, protocol-specified shoulder Home Exercise Program (HEP) starting 3 days after injection until the End of Study (EOS) Visit.

Both:

  • Written consent to participate in the study
  • Willing and able to comply with the study procedures and visit schedules and able to follow verbal and written instructions
  • (BMI) ≤ 40 kg/m2
  • Average daily mean shoulder pain with movement score ≥5.0 and ≤9.0 in the index shoulder (0 to 10 NRS) using the average daily ratings for at least 5 out of the 7 days prior to Day 1.
  • Shoulder pain present >15 days in the month prior to the Screening Visit
  • Willing to complete a washout of protocol-specified excluded medications 7 days prior to Day 1 and abstain from use of protocol-specified excluded medications throughout the study
  • Willing to abstain from nonpharmacological therapies for the index joint for 2 weeks prior to Day 1 and throughout the study.

Exclusion Criteria:

  • Has both glenohumeral OA and shoulder AC
  • Has bilateral AC
  • Has bilateral glenohumeral OA with glenohumeral OA pain of the shoulder contralateral to the index shoulder >3.0 (0 to 10 NRS) within 1 month prior to the Screening Visit
  • Has a history of arthritis in other joints of the index shoulder (as confirmed by medical history and physical exam)
  • Has a history or suspicion of full thickness rotator cuff tear in the index shoulder within 6 months of the Screening Visit
  • Has symptomatic partial rotator cuff tear, tendinopathy, tendonitis, or bursitis in the index shoulder within 6 months of the Screening Visit
  • Has a subchondral bone insufficiency fracture or humeral head necrosis/collapse in the index shoulder
  • Shoulder AC patients only: Has a history of shoulder surgery or radiotherapy
  • Glenohumeral OA patients only: Has a previous shoulder injury with functional limitation ≥1 month or surgery within 52 weeks of the Screening Visit
  • Has an index shoulder with major dysplasia or congenital abnormality, osteochondritis dissecans, acromegaly, ochronosis, hemochromatosis, Wilson's disease, or primary osteochondromatosis, or a history of avascular necrosis with secondary OA
  • Has current or history of infection in the index shoulder or current skin infection at injection site
  • Has a concurrent chronic pain condition with a pain score >3.0 (0 to 10 NRS) within 1 month prior to the Screening Visit
  • Has a history or current evidence of reactive arthritis, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, or arthritis associated with inflammatory bowel disease, systemic lupus erythematosus, calcium pyrophosphate dihydrate crystal deposition disease (CPPD), or other autoimmune diseases
  • Has any planned surgeries in the upper limbs during the study or any other surgery during the study that would require use of a restricted medication
  • Has surgical hardware or other foreign body present in the index shoulder
  • Has received an IA corticosteroid of any joint within 3 months of the Screening Visit
  • Has received an IA treatment of the index shoulder with any of the following agents within 6 months of the Screening Visit
  • Has received intravenous (IV), intrabursal, intratendinous, intramuscular (IM) or epidural corticosteroids within 3 months of the Screening Visit
  • Has received oral corticosteroids within 1 month of the Screening Visit
  • Has received inhaled, intranasal, or topical corticosteroids within 2 weeks of the Screening Visit
  • Has had significant changes to lifestyle with regard to physical activity and lifestyle within 1 month of the Screening Visit or any planned changes throughout the duration of the study
  • Has known hypersensitivity to TA or PLGA
  • Has laboratory evidence of infection with (HIV), a positive test for hepatitis B surface antigen (HBsAg), or positive serology for hepatitis C virus (HCV) with positive test for HCV ribonucleic acid
  • Has an electrocardiogram (ECG) abnormality
  • Has uncontrolled diabetes as indicated by a hemoglobin A1c of >8% (>59 mmol/mol).
  • Has a history of sarcoidosis or amyloidosis
  • Has a history of or active Cushing's syndrome
  • Has used chemotherapeutic agents, immunomodulators, or immunosuppressants within 5 years of the Screening Visit
  • Has current or history of malignancy within 5 years prior to the Screening Visit, except for basal or squamous cell carcinoma of the skin or cervical carcinoma in situ that has been treated successfully.
  • Has active substance use disorder or history of substance use disorder within 12 months prior to the Screening Visit
  • Has received a live or live attenuated vaccine within 3 months of the Screening Visit
  • Has used any other investigational drug, biologic, or device within 3 months of the Screening Visit
  • Has any infection requiring IV antibiotics 4 weeks prior to Day 1 or oral antibiotics 2 weeks prior to Day 1
  • Has a contraindication to the use of acetaminophen
  • Is a female that is pregnant or nursing or plans to become pregnant during the study; or is a male who plans to inseminate a partner or donate sperm during the 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 ClinicalTrials.gov identifier (NCT number): NCT04160091


Contacts
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Contact: Corrinne Lauze 781-305-7124 clauze@flexiontherapeutics.com
Contact: Brianna Fidler 781-305-7535 bfidler@flexiontherapeutics.com

Locations
Show Show 27 study locations
Sponsors and Collaborators
Flexion Therapeutics, Inc.
Medpace, Inc.
Investigators
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Study Director: Scott Kelley, MD Flexion Therapeutics, Inc.

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Responsible Party: Flexion Therapeutics, Inc.
ClinicalTrials.gov Identifier: NCT04160091    
Other Study ID Numbers: FX006-2018-016
First Posted: November 12, 2019    Key Record Dates
Last Update Posted: March 20, 2020
Last Verified: March 2020

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Studies a U.S. FDA-regulated Drug Product: Yes
Studies a U.S. FDA-regulated Device Product: No
Keywords provided by Flexion Therapeutics, Inc.:
Osteoarthritis
Adhesive Capsulitis
Shoulder
Pain
Intra-articular
Injection
Steroid
Additional relevant MeSH terms:
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Osteoarthritis
Bursitis
Arthritis
Joint Diseases
Musculoskeletal Diseases
Rheumatic Diseases