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    Summary
    EudraCT Number:2009-016466-82
    Sponsor's Protocol Code Number:cod16HS13
    National Competent Authority:Poland - Office for Medicinal Products
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2014-04-14
    Trial results View results
    Index
    A. PROTOCOL INFORMATION
    B. SPONSOR INFORMATION
    C. APPLICANT IDENTIFICATION
    D. IMP IDENTIFICATION
    D.8 INFORMATION ON PLACEBO
    E. GENERAL INFORMATION ON THE TRIAL
    F. POPULATION OF TRIAL SUBJECTS
    G. INVESTIGATOR NETWORKS TO BE INVOLVED IN THE TRIAL
    N. REVIEW BY THE COMPETENT AUTHORITY OR ETHICS COMMITTEE IN THE COUNTRY CONCERNED
    P. END OF TRIAL
    Expand All   Collapse All
    A. Protocol Information
    A.1Member State ConcernedPoland - Office for Medicinal Products
    A.2EudraCT number2009-016466-82
    A.3Full title of the trial
    Prospective, randomised, open label, multicentre Phase-III clinical trial to compare the efficacy and safety of the treatment with the autologous chondrocyte transplantation product co.don chondrosphere® (ACT3D-CS) with microfracture in subjects with cartilage defects of the knee with a defect size between 1 and 4 cm2
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    Clinical trial to compare the efficacy and safety of the treatment with the autologous chondrocyte transplantation product co.don chondrosphere® (ACT3D-CS) with microfracture in subjects with cartilage defects of the knee
    A.4.1Sponsor's protocol code numbercod16HS13
    A.7Trial is part of a Paediatric Investigation Plan No
    A.8EMA Decision number of Paediatric Investigation Plan
    B. Sponsor Information
    B.Sponsor: 1
    B.1.1Name of SponsorCO.DON AG
    B.1.3.4CountryGermany
    B.3.1 and B.3.2Status of the sponsorCommercial
    B.4 Source(s) of Monetary or Material Support for the clinical trial:
    B.4.1Name of organisation providing supportCO.DON AG
    B.4.2CountryGermany
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCO.DON AG
    B.5.2Functional name of contact pointCO.DON AG
    B.5.3 Address:
    B.5.3.1Street AddressErnst-Reuter-Platz 2
    B.5.3.2Town/ cityBerlin
    B.5.3.3Post code10587
    B.5.3.4CountryGermany
    B.5.4Telephone number+49302403523 11
    B.5.5Fax number+49302403523 09
    B.5.6E-maili.oefler@codon.de
    D. IMP Identification
    D.IMP: 1
    D.1.2 and D.1.3IMP RoleTest
    D.2 Status of the IMP to be used in the clinical trial
    D.2.1IMP to be used in the trial has a marketing authorisation No
    D.2.5The IMP has been designated in this indication as an orphan drug in the Community No
    D.2.5.1Orphan drug designation number
    D.3 Description of the IMP
    D.3.1Product nameco.don chondrosphere
    D.3.4Pharmaceutical form Living tissue equivalent
    D.3.4.1Specific paediatric formulation No
    D.3.7Routes of administration for this IMPIntraarticular use
    D.3.8 to D.3.10 IMP Identification Details (Active Substances)
    D.3.9.3Other descriptive nameViable autologous human cartilage-forming chondrocytes
    D.3.10 Strength
    D.3.10.1Concentration unit Other
    D.3.10.2Concentration typerange
    D.3.10.3Concentration number10 to 70
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin No
    D.3.11.2Active substance of biological/ biotechnological origin (other than Advanced Therapy IMP (ATIMP) No
    The IMP is a:
    D.3.11.3Advanced Therapy IMP (ATIMP) Yes
    D.3.11.3.1Somatic cell therapy medicinal product No
    D.3.11.3.2Gene therapy medical product No
    D.3.11.3.3Tissue Engineered Product Yes
    D.3.11.3.4Combination ATIMP (i.e. one involving a medical device) No
    D.3.11.3.5Committee on Advanced therapies (CAT) has issued a classification for this product No
    D.3.11.4Combination product that includes a device, but does not involve an Advanced Therapy No
    D.3.11.5Radiopharmaceutical medicinal product No
    D.3.11.6Immunological medicinal product (such as vaccine, allergen, immune serum) No
    D.3.11.7Plasma derived medicinal product No
    D.3.11.8Extractive medicinal product No
    D.3.11.9Recombinant medicinal product No
    D.3.11.10Medicinal product containing genetically modified organisms No
    D.3.11.11Herbal medicinal product No
    D.3.11.12Homeopathic medicinal product No
    D.3.11.13Another type of medicinal product No
    D.8 Information on Placebo
    E. General Information on the Trial
    E.1 Medical condition or disease under investigation
    E.1.1Medical condition(s) being investigated
    Cartilage defects of knee joints, osteochondral defects
    E.1.1.1Medical condition in easily understood language
    Cartilage defects of knee joints
    E.1.1.2Therapeutic area Diseases [C] - Musculoskeletal Diseases [C05]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level LLT
    E.1.2Classification code 10007713
    E.1.2Term Cartilage tear in knee
    E.1.2System Organ Class 10022117 - Injury, poisoning and procedural complications
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10007702
    E.1.2Term Cartilage biopsy
    E.1.2System Organ Class 100000004848
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10003423
    E.1.2Term Articular cartilage disorder
    E.1.2System Organ Class 100000004859
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10052913
    E.1.2Term Cartilage operation
    E.1.2System Organ Class 10042613 - Surgical and medical procedures
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10007705
    E.1.2Term Cartilage damage
    E.1.2System Organ Class 10022117 - Injury, poisoning and procedural complications
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level HLT
    E.1.2Classification code 10007709
    E.1.2Term Cartilage disorders
    E.1.2System Organ Class 100000004859
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10057104
    E.1.2Term Cartilage repair
    E.1.2System Organ Class 10042613 - Surgical and medical procedures
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.1
    E.1.2Level PT
    E.1.2Classification code 10007710
    E.1.2Term Cartilage injury
    E.1.2System Organ Class 10022117 - Injury, poisoning and procedural complications
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level PT
    E.1.2Classification code 10064112
    E.1.2Term Cartilage graft
    E.1.2System Organ Class 10042613 - Surgical and medical procedures
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    General Objectives:
    Assessment of the long-term efficacy and safety of the three-dimensional autologous chondrocyte transplantation product ACT3D-CS in comparison to microfracture for the treatment of cartilage defects of knee joints.
    The health economic outcomes are mainly intended to be assessed and evaluated as a basis for future negotiations with health insurances, health care providers and development of newly implemented procedural codes within the German DRG (Diagnosis Related Groups) system for ACT3D-CS.
    Primary data of the phase III study for evaluation of health economic outcomes are of main interest because in this design a comparison with another conventional treatment (microfracture) is given.

    Primary Objectives:
    Change of overall KOOS (Knee Injury and Osteoarthritis Outcome Score) from Day 0 (baseline for both treatment groups=day before arthroscopy) to final assessment (FA) at 24 months after the end of the respective treatment, compared between ACT3D-CS and MF.
    E.2.2Secondary objectives of the trial
    see protocol
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    1. Male or female patients, age: between 18 and 50 years
    2. Defect: isolated ICRS grade III or IV single defect chondral lesion on femoral condyle
    3. Defect size: 1 to < 4 cm2 after debridement to healthy cartilage up to 6 mm in depth. Assessment with MRI at screening and per estimation during arthroscopy prior to randomization
    4. Nearly intact chondral structure surrounding the defect as well as an intact corresponding joint area
    5. Informed consent signed and dated by patient
    6. Patient understands the strict rehabilitation protocol and follow-up programme and is willing to follow it
    7. In case of pain, patient agrees to use only paracetamol mono- (max 4 g/day) or combination preparation and oral and/or topic NSAIDs during the trial and to discontinue the use of oral and/or topic NSAIDs and/or paracetamol combination preparation 1 week before each visit whereas the use of paracetamol mono-preparation (max 4 g/day) is allowed. However, in the morning of the visit day, no pain medication is allowed. Other pain medications are allowed during surgical procedure and may be taken for a period not exceeding 4 weeks after surgery.
    E.4Principal exclusion criteria
    1. Defects on both knees at the same time
    2. Radiological signs of osteoarthritis
    3. Osteochondritis dissecans (OCD)
    4. Any signs of knee instability
    5. Valgus or varus malalignment (more than 5° over the mechanical axis)
    6. Clinically relevant second cartilage lesion on the same knee
    7. More than 50 % resection of a meniscus in the affected knee or incomplete meniscal rim
    8. Rheumatoid arthritis, parainfectious or infectious arthritis, and condition after these diseases
    9. Pregnancy and planned pregnancy (no MRI possible)
    10. Obesity (Body Mass Index >30)
    11. Uncontrolled diabetes mellitus
    12. Serious illness
    13. Poor general health as judged by physician
    14. Participation in concurrent clinical trials or previous trials within 3 months of screening
    15. Previous treatment with ACT in the affected knee
    16. Microfracture performed less than 1 year before screening in the affected knee
    17. Alcohol or drug (medication) abuse
    18. Meniscal transplant in the affected knee
    19. Meniscal suture (in the affected knee) three months prior to baseline
    20. Mosaicplasty (Osteoarticular Transplant System, OATS) in the affected knee
    21. Having received hyaluronic acid intra-articular injections in the affected knee within the last 3 months before baseline
    22. Taking specific ostheoarthritis drugs such as chondroïtin sulfate, diacerein, n-glucosamine, piascledine, capsaicin within 2 weeks before baseline
    23. Corticosteroid treatment by intraarticular route within the last month of baseline or systemic (all routes) corticosteroids within the last 2 weeks before baseline
    24. Chronic use of anticoagulants
    25. Any concomitant painful or disabling disease of the spine, hips or lower limbs that would interfere with evaluation of the afflicted knee
    26. Any clinically significant or symptomatic vascular or neurological disorder of the lower extremities
    27. Any evidence of the following diseases in the affected knee: septic arthritis, inflammatory joint disease, recurrent episodes of pseudogout, Paget's disease of bone, ochronosis, acromegaly, haemochromatosis, Wilson's disease, primary osteochondromatosis, heritable disorders, collagen gene mutation
    28. Current diagnosis of osteomyelitis, human immunodeficiency virus (HIV-1, -2) and/or hepatitis C virus (HCV) infection
    E.5 End points
    E.5.1Primary end point(s)
    Change of overall KOOS (Knee Injury and Osteoarthritis Outcome Score) from Day 0 (baseline for both treatment groups = day before arthroscopy) to Final Assessment (FA) at 24 months after the end of the respective treatment, compared between ACT3D-CS and MF.
    E.5.1.1Timepoint(s) of evaluation of this end point
    2017
    E.5.2Secondary end point(s)
    Change of overall KOOS from baseline (Day 0) to 12 months (interim analysis, IA), to 36, 48, 60 months (follow-up, FU) after the end of the respective treatment , compared between ACT3D-CS and MF

    Change of overall KOOS from Day 0 for microfracture or from Day 0’ for ACT3D-CS to 12, 24, 36, 48 and 60 months after the end of the respective treatment

    Change of the 5 subscores of the KOOS (Pain, other Symptoms, Function in daily living (ADL), Function in sport and recreation (Sport/Rec), knee related Quality of life (QoL)) for both treatment groups from Day 0 (day before arthroscopy) to 12 months (IA), to final assessment (FA) at 24 months, and to 36, 48, 60 months (follow-up, FU) after the end of the respective treatment, compared between ACT3D-CS and MF.

    MOCART (MRI Score) at 12, 24, 36, 48 and 60 months after transplantation or microfracture compared between ACT3D-CS and MF

    Arthroscopy and Biopsy at 24 months after transplantation/ microfracture, assessment of cartilage repair after ACT3D and microfracture to be compared between ACT3D-CS and MF

    ICRS Visual Histological Assessment Score at final assessment (24 months) compared between ACT3D-CS and MF

    Bern Score and additional histological assessment scores at final assessment (24 months) compared between ACT3D-CS and MF

    Change of ICRS/IKDC from baseline (Day 0) to 12, 24, 36, 48 and 60 months after the end of the respective treatment, compared between ACT3D-CS and MF

    Change of modified Lysholm Score from baseline (Day 0) to 12, 24, 36, 48 and 60 months after the end of the respective treatment compared between ACT3D-CS and MF

    Days of absence from work (employment) and/or days of inability to follow usual activities during the last year or since the last visit, respectively, and time point when patient was back to work and/or to follow usual activities
    E.5.2.1Timepoint(s) of evaluation of this end point
    2021
    E.6 and E.7 Scope of the trial
    E.6Scope of the trial
    E.6.1Diagnosis No
    E.6.2Prophylaxis No
    E.6.3Therapy Yes
    E.6.4Safety Yes
    E.6.5Efficacy Yes
    E.6.6Pharmacokinetic No
    E.6.7Pharmacodynamic No
    E.6.8Bioequivalence No
    E.6.9Dose response No
    E.6.10Pharmacogenetic No
    E.6.11Pharmacogenomic No
    E.6.12Pharmacoeconomic Yes
    E.6.13Others No
    E.7Trial type and phase
    E.7.1Human pharmacology (Phase I) No
    E.7.1.1First administration to humans No
    E.7.1.2Bioequivalence study No
    E.7.1.3Other No
    E.7.1.3.1Other trial type description
    E.7.2Therapeutic exploratory (Phase II) No
    E.7.3Therapeutic confirmatory (Phase III) Yes
    E.7.4Therapeutic use (Phase IV) No
    E.8 Design of the trial
    E.8.1Controlled Yes
    E.8.1.1Randomised Yes
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group Yes
    E.8.1.6Cross over No
    E.8.1.7Other No
    E.8.2 Comparator of controlled trial
    E.8.2.1Other medicinal product(s) No
    E.8.2.2Placebo No
    E.8.2.3Other Yes
    E.8.2.3.1Comparator description
    Comparative intervention: Microfracture (MF)
    E.8.2.4Number of treatment arms in the trial2
    E.8.3 The trial involves single site in the Member State concerned No
    E.8.4 The trial involves multiple sites in the Member State concerned Yes
    E.8.4.1Number of sites anticipated in Member State concerned3
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA14
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA No
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.7Trial has a data monitoring committee No
    E.8.8 Definition of the end of the trial and justification where it is not the last visit of the last subject undergoing the trial
    The visit at FU-60 (60 months after transplantation/MF) is defined as the end of the trial according to the protocol.
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years6
    E.8.9.1In the Member State concerned months0
    E.8.9.1In the Member State concerned days0
    E.8.9.2In all countries concerned by the trial years9
    E.8.9.2In all countries concerned by the trial months6
    E.8.9.2In all countries concerned by the trial days0
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero Information not present in EudraCT
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) Information not present in EudraCT
    F.1.1.3Newborns (0-27 days) Information not present in EudraCT
    F.1.1.4Infants and toddlers (28 days-23 months) Information not present in EudraCT
    F.1.1.5Children (2-11years) Information not present in EudraCT
    F.1.1.6Adolescents (12-17 years) Information not present in EudraCT
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 102
    F.1.3Elderly (>=65 years) No
    F.2 Gender
    F.2.1Female Yes
    F.2.2Male Yes
    F.3 Group of trial subjects
    F.3.1Healthy volunteers No
    F.3.2Patients Yes
    F.3.3Specific vulnerable populations Yes
    F.3.3.1Women of childbearing potential not using contraception For clinical trials recorded in the database before the 10th March 2011 this question read: "Women of childbearing potential" and did not include the words "not using contraception". An answer of yes could have included women of child bearing potential whether or not they would be using contraception. The answer should therefore be understood in that context. This trial was recorded in the database on 2014-04-14. Yes
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women Yes
    F.3.3.5Emergency situation No
    F.3.3.6Subjects incapable of giving consent personally No
    F.3.3.7Others No
    F.4 Planned number of subjects to be included
    F.4.1In the member state40
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 102
    F.4.2.2In the whole clinical trial 102
    F.5 Plans for treatment or care after the subject has ended the participation in the trial (if it is different from the expected normal treatment of that condition)
    Treatment according to normal standards of care of this condition.
    G. Investigator Networks to be involved in the Trial
    N. Review by the Competent Authority or Ethics Committee in the country concerned
    N.Competent Authority Decision Authorised
    N.Date of Competent Authority Decision2014-05-26
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2014-04-28
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2020-02-28
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