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Completed

NCT Number: NCT04229394

2ccPA Study in Patients With Symptomatic Knee Osteoarthritis

This clinical trial is designed to determine safety and tolerability as well as the MTD of a single-dose 2ccPA and PK data in symptomatic knee OA.

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Key information

Age range

40 year–75 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Kaohsiung Chang Gung Memorial Hospital, Taipei, Taiwan

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About this study

Osteoarthritis (OA) is a degenerative disease frequently associated with symptoms such as inflammation, stiffness, muscle weakness, joint swollen and joint pain. 2-carba-cyclic phosphatidic acid (2ccPA) is the derivative of natural occurring phospholipid mediator, cyclic phosphatidic acid (cPA). Previous studies suggested that 2ccPA inhibits inflammation and may relieve the pain caused by osteoarthritis.

This clinical study aims to assess the safety, tolerability, and pharmacokinetics as well as the maximal tolerated dose (MTD) of a single-dose 2ccPA in symptomatic knee OA. Safety and efficacy data for the design and conduction of subsequent studies will also be collected.

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Male or female subjects who are aged between 40 and 75 years old (inclusive)
  • Subjects diagnosed with symptomatic knee OA for at least 6 months prior to study entry (randomization)
  • Subjects whose radiographic evidence of knee OA are classified as grade II or III (according to Kellgren and Lawrence grading system)
  • Subjects with OA knee pain on the majority of days in the past 30 days prior to study entry (randomization).
  • A score of over 8 and below 16 out of 20 for the WOMAC pain subscale in the index knee in screening
  • Male subjects must agree to practice medically acceptable contraceptive regimen (i.e., sterilization surgery, barrier method, abstention) from screening visit until at least 1 month after the study treatment.
  • Subjects who are willing to sign the informed consent form (ICF)
  • Subjects with normal liver and renal function:

ALT and AST do not exceed 1.5 ULN (upper limit of normal) Serum Cr levels do not exceed 1.0 ULN

Exclusion criteria

  • Subjects with known hypersensitivity to study medication
  • Female subjects who are pregnant or lactating. Women of childbearing potential must agree to practice medically acceptable contraceptive regimen from screening visit until at least 1 month after the study treatment and must have a negative urine pregnancy test no earlier than 72 hours prior to study treatment.
  • Intra-articular use of corticosteroid, hyaluronic acid or other intra-articular injection in study knee within 3 months prior to study entry (randomization)
  • Use of chondroitin and/ or glucosamine within 4 weeks prior to study entry (randomization)
  • Subjects with known malignancy
  • History of Reiter's syndrome, rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, lymphoma, arthritis associated with inflammatory bowel disease, sarcoidosis and amyloidosis
  • Prior arthroscopic or open surgery on the study knee within 6 months prior to study entry (randomization)
  • Clinical signs and symptoms of active knee infection or being treated for knee infection at screening
  • Patients with active inflammation: patients with CRP higher than upper limit of normal range at screening visit will be excluded from the study.
  • Subjects with concurrent medical or arthritic condition that could interfere with evaluation of the index knee joint, including fibromyalgia, based on investigator's clinical judgment
  • More significant pain from the back or the hip than the knee
  • Skin breakdown or lesion on the study knee that is not suitable for injection, based on investigator's discretion
  • Prior knee replacement on the study knee or planned knee replacement during the study period
  • Subjects with (1) meniscus tears which requires repairment surgery OR (2) anterior cruciate ligament rupture based on screening MRI results
  • Patients with known severe synovitis, synovium necrosis in the target knee joint judged by investigator at screening
  • Patients with PT/ APTT higher than the upper limit of normal range at screening
  • History of drug or alcohol dependence in the past 3 years
  • Having known infection with HIV-1, HBV, HCV
  • Use of any investigational drug or participation in any drug study within 4 weeks prior to study entry (randomization)
  • Subjects who are unwilling or unable to comply with study procedures
  • Any clinical condition, including the presence of laboratory abnormalities, which places the subject at unacceptable risk to participate in the study or confounds the ability to interpret data from the study as judged by the investigator.

Treatment and study plan

2ccPA

Drug

Four dose cohorts (50 μg, 200 μg, 800 μg, and 2,400 μg) are planned in this study sequentially.

study group: one dose intra-articular on day1

Other names: 2-carba-cyclic phosphatidic acid

Placebo

Drug

A total of 8 subjects will be recruited and randomized in each dose cohort with a 3:1 ratio (6 subjects in the 2ccPA treatment arm and 2 subjects in the placebo arm).

control group: one dose intra-articular on day 1

Primary outcomes

  1. Adverse events will be coded with MedDRA and analyzed by system organ class (SOC) and preferred term. The number of subjects who experience DLT will be calculated at each dose level and the result of MTD will be provided.

    Time frame: 85 days

    To determine safety and tolerability as well as the maximal tolerated dose (MTD) of a single-dose 2ccPA in symptomatic knee OA

Secondary outcomes

  1. 20% improvement in the The Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain and physical function subscales

    Time frame: 85 days

    Proportion of subjects with a 20% improvement in the WOMAC pain and physical function subscales on Day 2, Day 3, Day 8, Day 15, Day 29 post treatment, compared with placebo group and baseline

  2. 50% improvement in the The Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain and physical function subscales

    Time frame: 85 days

    Proportion of subjects with a 50% improvement in the WOMAC pain and physical function subscales on Day 2, Day 3, Day 8, Day 15, Day 29 post treatment, compared with placebo group and baseline

  3. 70% improvement in the The Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain and physical function subscales

    Time frame: 85 days

    Proportion of subjects with a 70% improvement in the WOMAC pain and physical function subscales on Day 2, Day 3, Day 8, Day 15, Day 29 post treatment, compared with placebo group and baseline

  4. Maximum plasma concentration (Cmax) of 2ccPA

    Time frame: at baseline (pre-dose), 15 ± 5 minutes, 30 ± 5 minutes, 1 hour ± 10 minutes, 2 hours ± 10 minutes, 4 hours ± 10 minutes, 6 hours ± 10 minutes, 8 hours ± 10 minutes, 12 ± 2 hours, 24 ± 2 hours (Day 2) and 48 ± 2 hours (Day 3) after 2ccPA treatment.

    Pharmacokinetic profile of 2ccPA

  5. Time to maximum plasma concentration (Tmax) of 2ccPA

    Time frame: at baseline (pre-dose), 15 ± 5 minutes, 30 ± 5 minutes, 1 hour ± 10 minutes, 2 hours ± 10 minutes, 4 hours ± 10 minutes, 6 hours ± 10 minutes, 8 hours ± 10 minutes, 12 ± 2 hours, 24 ± 2 hours (Day 2) and 48 ± 2 hours (Day 3) after 2ccPA treatment.

    Pharmacokinetic profile of 2ccPA

  6. Area under plasma concentration-time curve (AUC) of 2ccPA

    Time frame: at baseline (pre-dose), 15 ± 5 minutes, 30 ± 5 minutes, 1 hour ± 10 minutes, 2 hours ± 10 minutes, 4 hours ± 10 minutes, 6 hours ± 10 minutes, 8 hours ± 10 minutes, 12 ± 2 hours, 24 ± 2 hours (Day 2) and 48 ± 2 hours (Day 3) after 2ccPA treatment.

    Pharmacokinetic profile of 2ccPA

  7. Apparent total body clearance (CL/F) of 2ccPA

    Time frame: at baseline (pre-dose), 15 ± 5 minutes, 30 ± 5 minutes, 1 hour ± 10 minutes, 2 hours ± 10 minutes, 4 hours ± 10 minutes, 6 hours ± 10 minutes, 8 hours ± 10 minutes, 12 ± 2 hours, 24 ± 2 hours (Day 2) and 48 ± 2 hours (Day 3) after 2ccPA treatment.

    Pharmacokinetic profile of 2ccPA

  8. Apparent volume of distribution (Vz/F) of 2ccPA

    Time frame: at baseline (pre-dose), 15 ± 5 minutes, 30 ± 5 minutes, 1 hour ± 10 minutes, 2 hours ± 10 minutes, 4 hours ± 10 minutes, 6 hours ± 10 minutes, 8 hours ± 10 minutes, 12 ± 2 hours, 24 ± 2 hours (Day 2) and 48 ± 2 hours (Day 3) after 2ccPA treatment.

    Pharmacokinetic profile of 2ccPA

  9. Elimination half-life (t1/2) of 2ccPA

    Time frame: at baseline (pre-dose), 15 ± 5 minutes, 30 ± 5 minutes, 1 hour ± 10 minutes, 2 hours ± 10 minutes, 4 hours ± 10 minutes, 6 hours ± 10 minutes, 8 hours ± 10 minutes, 12 ± 2 hours, 24 ± 2 hours (Day 2) and 48 ± 2 hours (Day 3) after 2ccPA treatment.

    Pharmacokinetic profile of 2ccPA

  10. Synovial fluid 2ccPA level

    Time frame: before intra-articular injection treatment and 24 hours ± 2 hours after intra-articular injection.

    Changes from baseline (pre-dose) in synovial fluid 2ccPA and synovial fluid matrix metalloproteinase (MMP)-1, -3 and -13 levels at 24 hours after 2ccPA treatment

  11. Synovial fluid matrix metalloproteinase (MMP)-1 level

    Time frame: before intra-articular injection treatment and 24 hours ± 2 hours after intra-articular injection.

    Changes from baseline (pre-dose) in synovial fluid 2ccPA and synovial fluid matrix metalloproteinase (MMP)-1, -3 and -13 levels at 24 hours after 2ccPA treatment

  12. Synovial fluid matrix metalloproteinase (MMP)-3 level

    Time frame: before intra-articular injection treatment and 24 hours ± 2 hours after intra-articular injection.

    Changes from baseline (pre-dose) in synovial fluid 2ccPA and synovial fluid matrix metalloproteinase (MMP)-1, -3 and -13 levels at 24 hours after 2ccPA treatment

  13. Synovial fluid matrix metalloproteinase (MMP)-13 level

    Time frame: before intra-articular injection treatment and 24 hours ± 2 hours after intra-articular injection.

    Changes from baseline (pre-dose) in synovial fluid 2ccPA and synovial fluid matrix metalloproteinase (MMP)-1, -3 and -13 levels at 24 hours after 2ccPA treatment

  14. Serum prostaglandin E2 (PGE2) level

    Time frame: at 1 hour, 12 hours, 24 hours, 48 hours, Day 8 and Day 15 (PGE2 only) after 2ccPA treatment

    Changes from baseline (pre-dose) in serum prostaglandin E2 (PGE2) levels at 30 minutes, 1 hour, 2 hours, 4 hours, 12 hours and 24 hours after 2ccPA treatment

  15. Serum matrix metalloproteinase (MMP)-1 level

    Time frame: at 1 hour, 12 hours, 24 hours, 48 hours, Day 8 and Day 15 (PGE2 only) after 2ccPA treatment

    Changes from baseline (pre-dose) in serum matrix metalloproteinase (MMP)-1,at 30 minutes, 1 hour, 2 hours, 4 hours, 12 hours and 24 hours after 2ccPA treatment

  16. Serum matrix metalloproteinase (MMP)-3 levels

    Time frame: at 1 hour, 12 hours, 24 hours, 48 hours, Day 8 and Day 15 (PGE2 only) after 2ccPA treatment

    Changes from baseline (pre-dose) in serum matrix metalloproteinase (MMP)-3,at 30 minutes, 1 hour, 2 hours, 4 hours, 12 hours and 24 hours after 2ccPA treatment

  17. Serum matrix metalloproteinase (MMP)-13 level

    Time frame: at 1 hour, 12 hours, 24 hours, 48 hours, Day 8 and Day 15 (PGE2 only) after 2ccPA treatment

    Changes from baseline (pre-dose) in serum matrix metalloproteinase (MMP)-13,at 30 minutes, 1 hour, 2 hours, 4 hours, 12 hours and 24 hours after 2ccPA treatment

  18. Plasma concentration of 2ccPA

    Time frame: at pre-dose and at 15 minutes, 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 8 hours, 12 hours, 24 hours and 48 hours after 2ccPA treatment

    Plasma concentration of 2ccPA at pre-dose and at 15 minutes, 30 minutes, 1 hour, 2 hours, 4 hours, 6 hours, 8 hours, 12 hours, 24 hours and 48 hours after 2ccPA treatment

  19. Joint space narrowing

    Time frame: 85 days

    To investigate joint space narrowing by MRI at Day 85, compared with baseline and the placebo group

  20. Ectopic bone formation

    Time frame: 85 days

    To investigate ectopic bone formation by MRI at Day 85, compared with baseline and the placebo group

Sponsors and collaborators

Lead sponsor

Orient Europharma Co., Ltd.

Industry

Registry information

Official study title

Phase I Safety, Tolerability, and Pharmacokinetics Study of 2ccPA in Patients With Symptomatic Knee Osteoarthritis

Important dates

Study start
2018
Primary completion
2021
Study completion
2021
First posted
Jan 18, 2020
Registry last updated
Apr 30, 2021

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

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