E.1 Medical condition or disease under investigation |
E.1.1 | Medical condition(s) being investigated |
Painful osteoarthritis of the knee |
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E.1.1.1 | Medical condition in easily understood language |
Chronic pain due to progressive degenerative joint disease |
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E.1.1.2 | Therapeutic area | Diseases [C] - Musculoskeletal Diseases [C05] |
MedDRA Classification |
E.1.2 Medical condition or disease under investigation |
E.1.2 | Version | 20.0 |
E.1.2 | Level | PT |
E.1.2 | Classification code | 10031161 |
E.1.2 | Term | Osteoarthritis |
E.1.2 | System Organ Class | 10028395 - Musculoskeletal and connective tissue disorders |
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E.1.3 | Condition being studied is a rare disease | No |
E.2 Objective of the trial |
E.2.1 | Main objective of the trial |
To assess the efficacy of MEDI7352 compared to placebo on chronic pain in participants with painful OA of the knee |
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E.2.2 | Secondary objectives of the trial |
To assess the efficacy of MEDI7352 compared to placebo on additional measures of efficacy in participants with painful OA of the knee
To assess the PK and immunogenicity of MEDI7352 in participants with painful OA of the knee
To assess the safety and tolerability of MEDI7352 compared with placebo in participants with painful OA of the knee
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E.2.3 | Trial contains a sub-study | No |
E.3 | Principal inclusion criteria |
Males or postmenopausal or surgically sterile females, 18 to 80 years of age Men who are biologically capable of having children must use an adequate form of contraception during the treatment period and for 3 months and 20 days after the last IP administration BMI ≤ 39 kg/m2 OA of one knee (ACR criteria) Radiological features consistent with a diagnosis of OA Pain in the moderate-to-severe range and pain most days in the past 3 months Pain must exceed pain experienced in other joints and pain from any concurrent medical conditions History of inadequate pain relief from past or ongoing treatment with paracetamol and oral NSAIDs/COX 2 inhibitors unless contraindicated/not tolerated and opoids unless (a) there is no access to opoids as per local standards of care, (b) there is no access to opoids as per local standards of care, or (c) the patient is unwilling to take opoids. Mean pain intensity score ≥ 5 in the target knee (11 point NRS) Willingness/ability to discontinue analgesic therapy for OA with NSAID or COX 2 inhibitors during the entire study
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E.4 | Principal exclusion criteria |
Treatment with another biologic therapeutic agent, DMARD or other immunosuppressants Previous treatment with any form of anti-NGF; received anti-TNFs or other biological DMARD in the past 12 months, or other immunosuppressants in the past 6 months Treatment with strong opioids RA History of gout Comorbid condition known to be associated with other forms of arthritis or joint pathology other than OA RPOA, primary osteonecrosis, subchondral insufficiency fractures, avascular necrosis, osteoporotic fractures, hip dislocation, pathological fractures or stress facture or reaction Significant trauma to a knee, hip, or shoulder within the previous year Candidates unsuitable for joint replacement surgery Neuropathic pain or chronic primary pain syndromes eg fibromyalgia OA of other major joints that could interfere with assessment of pain Clinically significant neuropathy Wheelchair required for mobility History or current diagnosis of severe major depression, psychotic disorders, somatoform disorders, bipolar disorders. suicidal attempts, hospital admission for depression within the past 5 years or any other of psychiatric illness likely to confound drug effect, pain assessment or ability to complete the study Significant cardiovascular disease Significant or chronic lung disease Diabetes complicated with retinopathy or nephropathy; HBA1c > 8.5 Known or suspected systemic infection, including HIV, HBV, HCV or TB History of an opportunistic infection or residence in areas with endemic fungal infections History or evidence of demyelinating disorder or epilepsy History of anaphylatic/severe hypersensitivity reactions, history of hypersensitivity to immunisations or immunoglobulins and/or biological therapies, ongoing hypersensitivity reactions Lifetime history of haematopoietic malignancies, history of other specified cancers within 5 years, or diagnosis of cancer between screening and randomisation TIA in the last 6 months, stroke in the past 12 months History of substance abuse within 2 years Current active infection, chronic or persistent systemic infection or serious or severe localised or systemic infection within 3 months prior to screening or between screening and randomisation or history of any underlying condition that predisposes to infection Any history of severe COVID 19 infection, or any prior COVID-19 infection with unresolved sequelae. Any acute COVID-19 infection, including asymptomatic, mild, or moderate that is not resolved 1 month prior to randomisation Current serious or unstable clinically important illness, including respiratory, CV, GI, endocrinologic, immunologic, haematologic, or neurological or other major disease likely to deteriorate or affect safety or ability to complete the study; liver cirrhosis Family history of long QT syndrome History of intolerability or contraindications to paracetamol Surgery to a knee, hip or shoulder within 1 year; non-diagnostic arthroscopy on the target knee joint within 180 days; diagnostic arthroscopy on the target knee within 90 days Corticosteroid or intra-articular hyaluronic acid injection on target knee within 12 weeks or corticosteroid injection on a nontarget joint within 12 weeks, or intra-articular hyaluronic acid injection on non target joint within 6 weeks prior to screening; for multiple injections within the year total dose of corticosteroid > 180 mg of triamcinolone, methylprednisolone, or their equivalent Intra-artciular platelet-rich plasma treatment on the target joint within 6 months Cell therapy on the target joint Any medical or surgical procedure or trauma within 28 days of first dose; planned surgical procedure during the study Contraindications to MRI Clinically important abnormality in physical examination, vital signs, ECG, or clinical laboratory test that may compromise participant safety,ability to complete the study or the integrity of trial data Significant hypertension (systolic BP > 165 mmHg and/or diastolic BP > 95 mmHg) Orthostatic hypotension. If it is not possible to establish stable supine BP participant is not eligible Any clinically significant abnormality in ECG rhythm, conduction, or morphology ALT, AST, or ALP > 2 ULN or > 1.5 x ULN total bilirubin Creatinine clearance < 50 ml/min Clinically significant abnormal findings in coagulation or haematology laboratory tests Positive pregnancy test Positive screen for drugs of abuse including cannabinoids without documented medical explanation Treatment with aspirin > 325 mg/day for CV prophylaxis or treatment with vitamin K dependent anticoagulants Administration of COVID-19 vaccine within 30 days prior to randomisation |
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E.5 End points |
E.5.1 | Primary end point(s) |
Change in the weekly average of daily NRS pain scores from baseline to Week 12 |
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E.5.1.1 | Timepoint(s) of evaluation of this end point |
Week 12 (NRS pain scores recorded daily) |
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E.5.2 | Secondary end point(s) |
Efficacy: Change in the WOMAC pain subscale from baseline to Week 12 Change in the WOMAC physical function subscale from baseline to Week 12 Change in the PGA of OA from baseline to Week 12
Serum concentration of MEDI7352 Presence of ADA to MEDI7352 ADA titre
Safety and tolerability evaluated based on AEs, vital signs, and clinical laboratory assessments |
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E.5.2.1 | Timepoint(s) of evaluation of this end point |
Efficacy: Week 12 (assessed at Weeks 1, 2, 4, 6, 8, 10, 12,18)
Safety and tolerability: Every study visit (Weeks 1, 2, 4, 6, 8, 10,11,12,15,18,21,24,28,32,36)
Serum concentrations and ADA: Weeks 0, 1, 2, 4, 6, 8, 10, 11, 12, 18, 32 |
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E.6 and E.7 Scope of the trial |
E.6 | Scope of the trial |
E.6.1 | Diagnosis | No |
E.6.2 | Prophylaxis | No |
E.6.3 | Therapy | Yes |
E.6.4 | Safety | Yes |
E.6.5 | Efficacy | Yes |
E.6.6 | Pharmacokinetic | Yes |
E.6.7 | Pharmacodynamic | Yes |
E.6.8 | Bioequivalence | No |
E.6.9 | Dose response | Yes |
E.6.10 | Pharmacogenetic | No |
E.6.11 | Pharmacogenomic | Yes |
E.6.12 | Pharmacoeconomic | Yes |
E.6.13 | Others | No |
E.7 | Trial type and phase |
E.7.1 | Human pharmacology (Phase I) | No |
E.7.1.1 | First administration to humans | No |
E.7.1.2 | Bioequivalence study | No |
E.7.1.3 | Other | No |
E.7.1.3.1 | Other trial type description | |
E.7.2 | Therapeutic exploratory (Phase II) | Yes |
E.7.3 | Therapeutic confirmatory (Phase III) | No |
E.7.4 | Therapeutic use (Phase IV) | No |
E.8 Design of the trial |
E.8.1 | Controlled | Yes |
E.8.1.1 | Randomised | Yes |
E.8.1.2 | Open | No |
E.8.1.3 | Single blind | No |
E.8.1.4 | Double blind | Yes |
E.8.1.5 | Parallel group | Yes |
E.8.1.6 | Cross over | No |
E.8.1.7 | Other | No |
E.8.2 | Comparator of controlled trial |
E.8.2.1 | Other medicinal product(s) | No |
E.8.2.2 | Placebo | Yes |
E.8.2.3 | Other | No |
E.8.2.4 | Number of treatment arms in the trial | 5 |
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.8.4.1 | Number of sites anticipated in Member State concerned | 4 |
E.8.5 | The trial involves multiple Member States | Yes |
E.8.5.1 | Number of sites anticipated in the EEA | 35 |
E.8.6 Trial involving sites outside the EEA |
E.8.6.1 | Trial being conducted both within and outside the EEA | Yes |
E.8.6.2 | Trial being conducted completely outside of the EEA | No |
E.8.6.3 | If E.8.6.1 or E.8.6.2 are Yes, specify the regions in which trial sites are planned |
South Africa |
Estonia |
Poland |
Spain |
Germany |
Denmark |
United Kingdom |
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E.8.7 | Trial has a data monitoring committee | Yes |
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
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E.8.9 Initial estimate of the duration of the trial |
E.8.9.1 | In the Member State concerned years | 1 |
E.8.9.1 | In the Member State concerned months | 2 |
E.8.9.1 | In the Member State concerned days | 2 |
E.8.9.2 | In all countries concerned by the trial years | 2 |
E.8.9.2 | In all countries concerned by the trial months | 6 |
E.8.9.2 | In all countries concerned by the trial days | 0 |