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    Summary
    EudraCT Number:2018-003094-10
    Sponsor's Protocol Code Number:CNTX-4975i-OA-303
    National Competent Authority:Spain - AEMPS
    Clinical Trial Type:EEA CTA
    Trial Status:Completed
    Date on which this record was first entered in the EudraCT database:2018-11-23
    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 ConcernedSpain - AEMPS
    A.2EudraCT number2018-003094-10
    A.3Full title of the trial
    An Open-label, 8-Week Study to Compare the Comfort and Ease of Use of Five Different Treatment Regimens for CNTX-4975-05 Intra-articular Injection in Subjects with Chronic, Moderate-to-Severe Osteoarthritis Knee Pain
    Estudio abierto, de 8 semanas, para comparar la comodidad y facilidad de uso de cinco pautas de tratamiento distintas de inyecciones intraarticulares de CNTX5 4975-05 en sujetos con dolor crónico de rodilla por artrosis moderada a grave
    A.3.1Title of the trial for lay people, in easily understood, i.e. non-technical, language
    A study to compare the comfort and ease of use of 5 different treatment regimens for trans-capsaicin injection into the knee in patients with moderate to severe osteoarthritis knee-pain
    Estudio para comparar la comodidad y facilidad de uso de cinco pautas de tratamiento diferentes de inyecciones de trans-capsaicina en la rodilla para pacientes con dolor crónico de rodilla por artrosis moderada a grave
    A.4.1Sponsor's protocol code numberCNTX-4975i-OA-303
    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 SponsorCentrexion Therapeutics Corp
    B.1.3.4CountryUnited States
    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 supportCentrexion Therapeutics Corp
    B.4.2CountryUnited States
    B.5 Contact point designated by the sponsor for further information on the trial
    B.5.1Name of organisationCentrexion Therapeutics Corp
    B.5.2Functional name of contact pointKimberley Guedes
    B.5.3 Address:
    B.5.3.1Street Address200 State Street, 6th Floor
    B.5.3.2Town/ cityBoston, MA
    B.5.3.3Post code02109
    B.5.3.4CountryUnited States
    B.5.4Telephone number+16178376920
    B.5.5Fax number+16174284545
    B.5.6E-mailkguedes@centrexion.com
    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 nameSynthetic Trans-Capsaicin for Injection
    D.3.2Product code CNTX-4975-05
    D.3.4Pharmaceutical form Solution for injection in pre-filled syringe
    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.3.8INN - Proposed INNCapsaicin
    D.3.9.1CAS number 404-86-4
    D.3.9.2Current sponsor codeCNTX-4975-05
    D.3.9.3Other descriptive nameTRANS- CAPSAICIN
    D.3.9.4EV Substance CodeSUB13229MIG
    D.3.10 Strength
    D.3.10.1Concentration unit mg/ml milligram(s)/millilitre
    D.3.10.2Concentration typeequal
    D.3.10.3Concentration number0.5
    D.3.11 The IMP contains an:
    D.3.11.1Active substance of chemical origin Yes
    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) No
    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 No
    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
    The index knee must show evidence of chronic OA with a K-L grade of 1, 2, 3 or 4.
    La rodilla de referencia debe mostrar indicios de artrosis crónica con grado K-L 1, 2, 3 o 4.
    E.1.1.1Medical condition in easily understood language
    Painful Osteoarthritis of the Knee
    Dolor de rodilla debido a artrosis
    E.1.1.2Therapeutic area Analytical, Diagnostic and Therapeutic Techniques and Equipment [E] - Anesthesia and Analgesia [E03]
    MedDRA Classification
    E.1.2 Medical condition or disease under investigation
    E.1.2Version 20.0
    E.1.2Level LLT
    E.1.2Classification code 10023476
    E.1.2Term Knee osteoarthritis
    E.1.2System Organ Class 100000004859
    E.1.3Condition being studied is a rare disease No
    E.2 Objective of the trial
    E.2.1Main objective of the trial
    The primary objective is to determine the optimal procedures for administering CNTX-4975-05 as a single IA injection into knee(s) with OA, balancing comfort and ease of use of methods of cooling and administration.
    El objetivo primario es determinar los procedimientos óptimos para administrar CNTX 4975-05 como una sola inyección intraarticular (i.a.) en la(s) rodilla(s) con artrosis, equilibrando la comodidad y la facilidad de uso de los métodos de enfriamiento y administración.
    E.2.2Secondary objectives of the trial
    • To describe the clinical benefit of CNTX-4975-05 treatment at Week 8 in a single knee with OA
    • To describe the clinical benefit at Week 8 of treating bilateral knee OA with a single injection to each knee
    • To describe the clinical benefit at Week 8 of treating a single knee with OA in subjects with partial joint replacement (PJR) or TJR in the contralateral knee
    • To evaluate subject satisfaction (SS) with the overall benefit of CNTX-4975-05
    • To evaluate SS with CNTX-4975-05 relative to SS with contralateral knee PJR or TJR
    • To evaluate SS and investigator satisfaction (IS) with different treatment regimens
    • To evaluate the responders to treatment through 8 weeks
    • Describir el beneficio clínico del tratamiento con CNTX-4975-05 en la semana 8 en una sola rodilla con artrosis.
    • Describir el beneficio clínico en la semana 8 del tratamiento de la artrosis de rodilla bilateral con una sola inyección en cada rodilla.
    • Describir el beneficio clínico en la semana 8 del tratamiento de una sola rodilla con artrosis en sujetos con artroplastia parcial o total (AP/AT) en la rodilla contraria.
    • Evaluar la satisfacción del sujeto (SS) con el beneficio general de CNTX 4975 05
    • Evaluar la SS con la CNTX 4975-05 i.a.. en comparación con la SS con la AP o la AT de la rodilla contraria.
    • Evaluar la satisfacción del sujeto y del investigador (SI) con diferentes pautas de tratamiento.
    • Evaluar a los pacientes que responden al tratamiento durante 8 semanas.
    E.2.3Trial contains a sub-study No
    E.3Principal inclusion criteria
    A subject will be eligible for study participation if the subject meets all of the following criteria:
    1. Male or female subjects between 40 and 95 years of age (inclusive).
    2. Confirmation of OA of the knee: radiography of both knees using standard standing films (scored by the investigator) or using the fixed flexion method, taken during the Screening Visit (prior radiographs of the knees of sufficient quality that have been taken within 2 years of the Screening Visit may be used for K-L grading). The index knee must show evidence of chronic OA with a K-L grade of 1, 2, 3 or 4. . Subjects who were screen failures for the US CNTX-4975i-OA-301 or CNTX-4975i-OA- 304 trials may be considered for this trial if the K-L grade of the index knee is 1-4, inclusive.
    3. Confirmation of OA of the index knee: American College of Rheumatology (ACR) diagnostic criteria (ACR confirmation of bilateral knee OA for subjects who will have bilateral knee injections of CNTX-4975-05).
    4. For subjects for monoarticular knee injection, the index knee must have moderate to severe pain (≥5 and ≤9) at screening associated with OA, which must be stable for a minimum of 6 months prior to Screening, as assessed by the investigator. These subjects may have:
    a) unilateral or bilateral OA, with the index knee having moderate to severe pain, and the contralateral knee having none to mild pain, OR
    b) unilateral or bilateral OA, with the index knee having moderate to severe pain and the other knee having had a PJR or TJR within 5 years of the Screening Visit. The knee with the PJR/TJR is not to be injected with CNTX-4975-05.
    For subjects for bilateral knee injection, the index knee must have moderate to severe pain (≥5 and ≤9) at screening associated with OA, and greater pain in the index knee than in the contralateral knee. Their pain must be stable for a minimum of 6 months prior to Screening, as assessed by the investigator. The index knee in these subjects is the one with the worst pain with walking. Where both knees have equal pain with walking, then the knee on the subject’s dominant side will be designated the index knee.
    For qualifying knee pain with walking, subjects will use an NPRS (0-10; 0=no pain, 10=worst possible pain) to rate their knee pain with walking (both knees, except knees with PJR/TJR). The PJR/TJR pain should be rated using the NPRS scale, but will not be a qualifying pain score.
    5. Body mass index ≤45 kg/m2.
    6. Subjects must have failed 2 or more prior therapies. Failure is deemed to be inadequate relief in the opinion of the investigator. A therapy may be deemed to have been inadequate because of one or more of the following:
    a) unacceptable AEs;
    b) initial failure to achieve clinically adequate pain relief;
    c) initial pain relief that was not maintained; and/or
    d) medical condition resulting in contraindication to the standard of care appropriate to the severity of the index knee OA pain.
    “Therapies” include, but are not limited to, the following: NSAIDs (including topical), opioids, duloxetine, other systemic therapy, IA corticosteroids, IA viscosupplements, physical therapy, bracing, and orthotics.
    7. Females not of childbearing potential, defined as post-menopausal for at least 1 year, or surgically sterile (bilateral tubal ligation, bilateral oophorectomy, or hysterectomy), or practicing one of the following medically acceptable methods of birth control throughout the study period:
    • Hormonal methods such as oral, implantable, injectable, or transdermal contraceptives for a minimum of 1 full cycle (based on the subject’s usual menstrual cycle period) before CNTX-4975-05 administration
    • Total abstinence from sexual intercourse since the last menses before CNTX-4975-05 administration
    • Intrauterine device
    • Double barrier method (condoms, sponge, diaphragm, with spermicidal jellies or cream).
    8. Able to speak, read, and understand the language of the study used for the informed consent.
    9. Willing and able to:
    a) understand the study requirements
    b) abide by the study restrictions and requirements
    c) complete the study procedures
    d) be compliant and independently (i.e., without assistance) record responses on the efficacy scales during clinic visits
    e) independently communicate meaningfully with the study personnel
    Un sujeto será elegible para participar en el estudio si cumple todos los criterios siguientes:
    1.Varones o mujeres de edades comprendidas entre 40-95 años (ambas inclusive).
    2.Confirmación de artrosis de rodilla: radiografías de ambas rodillas utilizando radiografías de pie estándar (puntuadas por el investigador) o el método de flexión fija, tomadas durante la visita de selección (radiografías previas de las rodillas con suficiente calidad obtenidas en los 2 años anteriores a la visita de selección se pueden utilizar para la clasificación K-L). La rodilla de referencia debe mostrar indicios de artrosis crónica con grado K-L 1, 2, 3 o 4. Los sujetos que fueron fallos de selección en los ensayos CNTX-4975i-OA 301 o CNTX-4975i-OA 304 de los Estados Unidos (EE. UU.) pueden considerarse para este ensayo si el grado K-L de la rodilla de referencia es 1-4, ambos inclusive.
    3.Confirmación de artrosis de la rodilla de referencia: Criterios diagnósticos del American College of Rheumatology (ACR).(confirmación ACR de artrosis de rodilla bilateral en los sujetos que recibirán inyecciones de rodilla bilaterales de CNTX-4975-05).
    4.En los sujetos que vayan a recibir inyecciones de rodilla monoarticulares, la rodilla de referencia debe tener dolor moderado a intenso (≥5 y ≤9) relacionado con la artrosis en la selección, que debe estar estable durante un mínimo de 6 meses antes de la selección, según la evaluación del investigador. Estos sujetos pueden tener:
    a)artrosis unilateral o bilateral, con dolor moderado a intenso en la rodilla de referencia y ausencia de dolor/dolor leve en la rodilla contraria, o
    b)artrosis unilateral o bilateral, con dolor moderado a intenso en la rodilla de referencia y AP o AT en la rodilla contraria en los 5 años anteriores a la visita de selección. No se debe inyectar CNTX-4975-05 en la rodilla con AP/AT.
    En los sujetos que reciban inyecciones de rodilla bilaterales, la rodilla de referencia debe tener dolor moderado a intenso (≥5 y ≤9) relacionado con la artrosis en la selección, y tener más dolor en la rodilla de referencia que en la contraria. El dolor debe haber estado estable durante un mínimo de 6 meses antes de la selección, según la evaluación del investigador. La rodilla de referencia en estos sujetos es aquella en la que siente más dolor al caminar. Cuando se note el mismo dolor al caminar en ambas rodillas, la rodilla del lado dominante se considerará la rodilla de referencia.
    Para calificar el dolor de rodilla al caminar los sujetos usarán una NPRS (de 0 a 10; 0=sin dolor, 10= peor dolor posible) para puntuar el dolor de rodilla al caminar (ambas rodillas, excepto las que tenga AP/AT). El dolor de la AP/AT debe puntuarse usando la escala NPRS, pero no será una puntuación de dolor apta.
    5.Índice de masa corporal ≤45 kg/m2.
    6.Fallo de 2 o más tratamientos anteriores en el sujeto. Se considerará fallo el alivio inadecuado del dolor, según opinión del investigador. Un tratamiento puede considerarse inadecuado debido a uno o más de los siguientes aspectos:
    a)acontecimientos adversos (AA) inaceptables
    b)incapacidad inicial de conseguir un alivio del dolor clínicamente adecuado
    c)alivio del dolor inicial no mantenido y/o
    d)afección médica que ocasione la contraindicación del tratamiento estándar apropiado para la intensidad del dolor por artrosis de la rodilla de referencia.
    Los «tratamientos» incluyen, sin carácter exclusivo: antiinflamatorios no esteroideos (AINE) (incluidos los tópicos), opioides, duloxetina, otros tratamientos sistémicos, corticosteroides i.a., viscosuplementos i.a., fisioterapia, soportes y aparatos ortopédicos.
    7.Mujeres que no estén en edad fértil, definidas como mujeres posmenopáusicas durante al menos 1 año o sometidas a esterilización quirúrgica (ligadura de trompas bilateral, ovariectomía bilateral o histerectomía), o que practiquen alguno de los siguientes métodos anticonceptivos médicamente aceptables durante todo el periodo del estudio:
    •Métodos hormonales, tales como anticonceptivos orales, implantables, inyectables o transdérmicos, durante un mínimo de 1 ciclo completo (basándose en el ciclo menstrual habitual de la paciente) antes de la administración de CNTX 4975 05.
    •Abstinencia absoluta de relaciones sexuales desde la última menstruación anterior a la administración de CNTX 4975 05
    •Dispositivo intrauterino
    •Método de doble barrera (preservativo, esponja o diafragma junto con geles o cremas espermicidas)
    8.Capacidad para hablar, leer y entender el lenguaje del estudio que se utiliza en el consentimiento informado.
    9.Disposición y capacidad para:
    a)Entender los requisitos del estudio
    b)Atenerse a las restricciones y requisitos del estudio
    c)Completar los procedimientos del estudio
    d)Cumplir las obligaciones y registrar las respuestas independientemente (sin ayuda) en las escalas de eficacia durante las visitas al centro
    e) Comunicarse independientemente y de forma suficiente con el personal del estudio
    E.4Principal exclusion criteria
    A subject will be excluded from the study if the subject meets any of the following criteria:
    1. Joint replacement surgery of the index knee at any time, or open surgery of the index knee in the past 24 months. Joint replacement of the contralateral knee is permitted for subjects who will not receive an injection in the contralateral (natural) knee. For subjects with bilateral knee OA who will receive an injection into both knees, joint replacement surgery of both knees at any time, or open surgery of the index knee in the past 24 months, is excluded.
    2. Prior arthroscopic surgery of the index knee within 6 months of Screening.
    3. Any painful conditions of the index knee due to joint disease other than OA. For example, radicular or referred pain involving the index knee or from joint disease other than OA involving the index knee, such as, but not restricted to chondromalacia patellae, inflammatory diseases (e.g., rheumatoid arthritis, psoriatic arthritis), metabolic diseases, gout/pseudogout, hemochromatosis, acromegaly, etc.
    4. Periarticular pain from any cause, including referred pain, bursitis, tendonitis, soft tissue tenderness, or subacute/acute pain from injury.
    5. Other chronic pain anywhere in the body that requires the use of chronic analgesic medications, including, but not limited to, local painful areas, myofascial pain syndromes, fibromyalgia, genetic, metabolic abnormalities, hematologic, or neuropathic pain.
    6. Instability of the index or contralateral knee (e.g., cruciate ligament tear or rupture, significant protruding meniscus, substantial ligamentous laxity, unstable PJR or TJR).
    7. Misalignment (>10 degrees varus or valgus) of the index knee on standing.
    8. Documented history of neuropathic arthropathy or finding of bony fragmentation in the index knee with imaging (radiographic, computed tomography, or magnetic resonance imaging).
    9. Physical/occupational/chiropractic therapy for the lower extremities or acupuncture for the lower extremities within 15 days of Screening, or need for such therapy during the study.
    10. Plans to have surgery, other invasive procedures, or IA injections (other than CNTX-4975-05) for either knee while participating in the study.
    11. Current use of opioids for any condition other than for OA of the knees injected with CNTX-4975-05) (maximum dose of 15 mg of hydrocodone [or equivalent] per day).
    12. Corticosteroid injection into the index or contralateral knee within 90 days of Screening.
    13. Received IA viscosupplementation (e.g., Synvisc®, Hyalgan®) within 90 days of Screening.
    14. History of allergic reaction to the planned local anesthesia/analgesic regimens, ethylenediaminetetraacetic acid, Kolliphor HS 15, butylated hydroxytoluene, or capsaicin.
    15. Presence of any medical condition or unstable health status that, in the judgment of the investigator, might adversely impact the safety of the subject, or the conduct of the study, or negatively affect the resulting data, including chronic conditions that are likely to alter the rate of healing or are likely to result in safety complications unrelated to the study medication, or significantly compromise key organ systems. For any question regarding eligibility, it is strongly recommended that the investigator discuss the subject with the medical monitor.
    16. Is pregnant or is breast feeding.
    17. Has a malignancy, a history of malignancy, or has received treatment for malignancy at any time, with exception of resected and cured basal cell carcinoma and squamous cell carcinoma of the skin.
    18. Regular use of anticoagulant blood thinners (except low-dose aspirin, Dabigatran 150 mg once daily [qd], Enoxaparin 40 mg qd, Rivaroxaban 10 mg qd, or Apixaban 2.5 mg twice daily [bid], or clopidogrel 75 mg qd, which are allowed).
    19. Active cutaneous disease at the anticipated site of CNTX-4975-05 injection that would prevent the safe administration of CNTX-4975-05.
    20. Ulcer or open wound anywhere on the index knee.
    21. Specific laboratory abnormalities:
    • Hemoglobin <11.0 g/dL
    • White blood cells <2.5 × 109/L
    • Neutrophils <1.5 × 109/L
    • Platelets <100 × 109/L
    • Aspartate transaminase or alanine transaminase >2 × upper limit of normal
    • Creatinine >1.6 mg/dL
    • Glucose (fasting) >250 mg/dL
    • Hemoglobin A1c (HgbA1c) >9.0%
    Un sujeto será excluido del estudio si cumple alguno de los siguientes criterios:
    1.Intervención quirúrgica de artroplastia de la rodilla de referencia en cualquier momento o cirugía abierta de la rodilla de referencia en los 24 últimos meses. Se permite la artroplastia de la rodilla contraria (natural) en sujetos que no van a recibir una inyección en dicha rodilla. Para sujetos con artrosis de rodilla bilateral que recibirán una inyección en ambas rodillas; se excluye la intervención quirúrgica de artroplastia en ambas rodillas en cualquier momento o cirugía abierta de la rodilla de referencia en los 24 últimos meses.
    2.Intervención quirúrgica artroscópica de la rodilla de referencia en los 6 meses previos a la selección.
    3.Afecciones dolorosas de la rodilla de referencia debidas a una enfermedad articular distinta a la artrosis (ej. dolor radicular o referido que afecta a la rodilla de referencia o debido a enfermedad articular distinta a artrosis que afecta la rodilla de referencia, entre otras, condromalacia rotuliana, enfermedades inflamatorias (artritis reumatoide, artritis psoriásica), enfermedades metabólicas, gota/pseudogota, hemocromatosis, acromegalia, etc.)
    4.Dolor periarticular por cualquier causa, incluido dolor referido, bursitis, tendinitis, dolor a la palpación de partes blandas o dolor subagudo/agudo debido a la lesión.
    5.Otro dolor crónico en cualquier parte del cuerpo que obligue al uso crónico de medicamentos analgésicos , incluidos, entre otros, dolores locales, síndromes de dolor miofascial, fibromialgia, anomalías genéticas o metabólicas, dolor hematológico o neuropático.
    6.Inestabilidad de la rodilla de referencia o contraria (p. ej., desgarro o rotura del ligamento cruzado, protrusión significativa del menisco, laxitud ligamentosa considerable, AP o AT inestables).
    7.Desviación (>10 grados de varo u valgo) de la rodilla de referencia en posición de pie.
    8.Antecedentes documentados de artropatía neuropática o hallazgos de fragmentación ósea en la rodilla de referencia con imágenes (radiográficas, por tomografía computarizada o por resonancia magnética).
    9.Fisioterapia, terapia ocupacional o quiropráctica en las extremidades inferiores o acupuntura de las extremidades inferiores en los 15 días anteriores a la selección o necesidad de dichas terapias durante el estudio.
    10.Previsión de someterse a intervención quirúrgica, otros procedimientos invasivos o inyecciones i.a. (distintas a la del CNTX-4975-05) en cualquiera de las rodillas durante la participación en el estudio.
    11.Uso actual de opioides para cualquier enfermedad distinta a la artrosis de las rodillas en las que se ha inyectado CNTX-4975-05 (dosis máxima de 15 mg de hidrocodona, o equivalente, al día).
    12.Inyección de corticosteroides en la rodilla de referencia o la contraria en los 90 días anteriores a la selección.
    13.Haber recibido viscosuplementación i.a. (p. ej., Synvisc®, Hyalgan®) en los 90 días anteriores a la selección.
    14.Antecedentes de reacción alérgica a los tratamientos anestésicos/analgésicos locales previstos, al ácido etilendiaminotetraacético, a Kolliphor HS 15, al hidroxitolueno butilado o a la capsaicina.
    15.Presencia de alguna afección médica o estado de salud inestable que, a juicio del investigador, podría afectar de forma adversa a la seguridad del sujeto o a la realización del estudio, o influir negativamente en los datos resultantes, incluidas afecciones crónicas que sea probable que alteren la velocidad de curación o que sea probable que conlleven complicaciones de seguridad no relacionadas con los medicamentos del estudio o que perjudiquen considerablemente sistemas de órganos importantes. Para cualquier pregunta relacionada con la idoneidad, se recomienda encarecidamente que el investigador comente el caso del sujeto con el monitor médico.
    16.Embarazo o lactancia.
    17.Padecer una neoplasia, antecedentes de neoplasia o haber recibido tratamiento para una neoplasia en cualquier momento, exceptuando el carcinoma basocelular resecado y curado y el carcinoma espinoceular de la piel.
    18.Uso habitual de fluidificadores sanguíneos anticoagulantes (excepto aspirina de dosis baja, 150 mg de dabigatrán una vez al día [1vd], 40 mg de enoxoparina 1vd, 10 mg de rivaroxabán 1vd, 2,5 mg de apixabán dos veces al día o 75 mg de clopidogrel 1vd, que están permitidos).
    19.Enfermedad cutánea activa en el lugar previsto para la inyección del CNTX 4975 05 que impediría una administración segura del CNTX 4975 05.
    20.Úlcera o herida abierta en cualquier parte de la rodilla de referencia.
    21.Anomalías específicas en los análisis clínicos:
    •Hemoglobina <11,0 g/dl
    •Leucocitos <2,5 x 109/l
    •Neutrófilos <1,5 x 109/l
    •Plaquetas <100 x 109/l
    •Aspartato transaminasa o alanina transaminasa >2 veces el límite superior de la normalidad
    •Creatinina >1,6 mg/dl
    •Glucosa (en ayunas) >250 mg/dl
    •Hemoglobina A1c (HgbA1c) >9,0 %
    E.5 End points
    E.5.1Primary end point(s)
    The primary endpoint is assessment of the CNTX-4975-05 treatment regimens, with the Breg Cooling Control Group as the standard, using a combination of 3 assessments of the index knee: 1) pain 30 minutes after CNTX-4975-05 injection (using the 0-4 scale of none, mild, moderate, moderately severe, and severe); 2) subject satisfaction with the treatment regimen (SS); and 3) investigator satisfaction with the treatment regimen (IS).
    El criterio de valoración principal es la evaluación de las pautas de tratamiento de CNTX-4975-05, con el grupo de control de enfriamiento de Breg como estándar, utilizando una combinación de 3 evaluaciones de la rodilla de referencia: 1) dolor 30 minutos después de la inyección de CNTX-4975-05 (usando la escala de 0 a 4: sin dolor, leve, moderado, moderadamente intenso e intenso; 2) satisfacción del sujeto (SS) con la pauta de tratamiento; y 3) satisfacción del investigador (SI) con la pauta de tratamiento.
    E.5.1.1Timepoint(s) of evaluation of this end point
    During treatment period
    Durante el periodo de tratamiento
    E.5.2Secondary end point(s)
    • Assessment of the primary combined outcome using the contralateral knee for the subjects who received bilateral injections and the index knee for all other subjects
    • Assessment of the primary combined outcome for each subject type
    • Assessment of the primary combined outcome, using the contralateral knee for the subjects who received bilateral injections
    • Percent of Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) responders at Week 8 for subjects with a single CNTX-4975-05 joint injection (index knee, moderate-to-severe pain; index knee, pain not >3 for contralateral knee)
    • Percent of OMERACT-OARSI responders at Week 8 for subjects with bilateral knee injections of CNTX-4975-05 (index knee, moderate-to-severe pain index knee; both knees meeting OMERACT-OARSI responder criteria)
    • Percent of OMERACT-OARSI responders at Week 8 for subjects with a single CNTX-4975-05 joint injection (population with index knee, moderate-to-severe pain index knee; non-index knee with PJR/TJR)
    • For each of the 3 types of subjects, the absolute change; the number of subjects who have ≥30%, ≥50%, ≥70%, or ≥90% improvement area under the curve; and landmark analysis on the 5 subscales of the KOOS through Week 8 using the average of both knees:
    o Pain
    o Other symptoms
    o Activities of daily living
    o Sports and recreation
    o Quality of life
    Assess the SS of treatment with CNTX-4975-05 IA injection for each of the 3 types of subjects, and all subjects in the trial
    • For subjects with a PJR/TJR, assess their satisfaction with the CNTX-4975-05 IA injection versus their satisfaction with their PJR/TJR
    •Evaluación del criterio de valoración principal combinado usando la rodilla contraria en los sujetos que reciban inyecciones bilaterales y la rodilla de referencia en todos los demás sujetos.
    •Evaluación del criterio de valoración principal combinado para cada tipo de sujeto.
    •Evaluación del criterio de valoración principal combinado usando la rodilla contraria en los sujetos que reciban inyecciones bilaterales.
    •Porcentaje de pacientes que responden según las medidas de resultados en reumatología [OMERACT] de la Osteoarthritis Research Society International [OARSI] en la semana 8 en los sujetos que reciben una sola inyección articular de CNTX-4975-05 (rodilla de referencia, dolor moderado a intenso; rodilla de referencia, el dolor no es >3 en la rodilla contraria).
    •Porcentaje de pacientes que responden según OMERACT-OARSI en la semana 8 en los sujetos que reciben inyecciones de rodilla bilaterales de CNTX-4975-05 (rodilla de referencia, dolor moderado a intenso en la rodilla de referencia; ambas rodillas cumplen los criterios de respuesta OMERACT-OARSI).
    •Porcentaje de pacientes que responden según OMERACT-OARSI en la semana 8 en los sujetos que reciben una sola inyecciones articular de CNTX-4975-05 (población de rodilla de referencia, dolor moderado a intenso en la rodilla de referencia; rodilla opuesta a la de referencia con AP/AT).
    •Para cada uno de los 3 tipos de sujetos, el cambio absoluto; el número de sujetos que tienen ≥30 %, ≥50 %, ≥70 % o ≥90 % de mejora del área bajo la curva; y el análisis de puntos de referencia en las 5 subescalas del KOOS hasta la semana 8 usando el promedio de ambas rodillas:
    oDolor
    oOtros síntomas
    oActividades de la vida diaria
    oDeportes y ocio
    oCalidad de vida
    •Se evalúa la SS con el tratamiento con la inyección i.a. de CNTX-4975-05 en cada uno de los 3 tipos de sujetos y en todos los sujetos del ensayo.
    •En los sujetos con AP/AT, se evalúa su satisfacción con la inyección i.a. de CNTX-4975-05 frente a su satisfacción con la AP/AT.
    E.5.2.1Timepoint(s) of evaluation of this end point
    During treatment period
    Durante el periodo de tratamiento
    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 No
    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 No
    E.8.1.1Randomised No
    E.8.1.2Open Yes
    E.8.1.3Single blind No
    E.8.1.4Double blind No
    E.8.1.5Parallel group No
    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 No
    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 concerned11
    E.8.5The trial involves multiple Member States Yes
    E.8.5.1Number of sites anticipated in the EEA22
    E.8.6 Trial involving sites outside the EEA
    E.8.6.1Trial being conducted both within and outside the EEA Yes
    E.8.6.2Trial being conducted completely outside of the EEA No
    E.8.6.3If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned
    United States
    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
    LVLS
    Última visita del último sujeto incluido
    E.8.9 Initial estimate of the duration of the trial
    E.8.9.1In the Member State concerned years0
    E.8.9.1In the Member State concerned months13
    E.8.9.1In the Member State concerned days
    E.8.9.2In all countries concerned by the trial years0
    E.8.9.2In all countries concerned by the trial months13
    F. Population of Trial Subjects
    F.1 Age Range
    F.1.1Trial has subjects under 18 No
    F.1.1.1In Utero No
    F.1.1.2Preterm newborn infants (up to gestational age < 37 weeks) No
    F.1.1.3Newborns (0-27 days) No
    F.1.1.4Infants and toddlers (28 days-23 months) No
    F.1.1.5Children (2-11years) No
    F.1.1.6Adolescents (12-17 years) No
    F.1.2Adults (18-64 years) Yes
    F.1.2.1Number of subjects for this age range: 300
    F.1.3Elderly (>=65 years) Yes
    F.1.3.1Number of subjects for this age range: 75
    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 No
    F.3.3.2Women of child-bearing potential using contraception Yes
    F.3.3.3Pregnant women No
    F.3.3.4Nursing women No
    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 state188
    F.4.2 For a multinational trial
    F.4.2.1In the EEA 375
    F.4.2.2In the whole clinical trial 850
    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)
    After the end of the study, each subject will be treated according to standard clinical practice
    Tras el final del estudio, cada sujeto será tratado conforme a la práctica clínica habitual.
    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 Decision2018-11-30
    N.Ethics Committee Opinion of the trial applicationFavourable
    N.Ethics Committee Opinion: Reason(s) for unfavourable opinion
    N.Date of Ethics Committee Opinion2018-11-28
    P. End of Trial
    P.End of Trial StatusCompleted
    P.Date of the global end of the trial2019-10-17
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