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OpenTrials
Completed

NCT Number: NCT02873273

Study of a Steroid Delivery System for Pain Relief Treatment in Patients With Knee Osteoarthritis

The purpose of this study is to determine whether a longer duration, controlled, sustained release dexamethasone delivery system would be more effective in helping patients with osteoarthritis reduce their pain, remain functional, and delay their need for knee replacement.

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Key information

Age range

40 year–99 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Phase 1

Primary location

Hospital for Special Surgery

New York, 10021, United States

About this study

The objectives of the study are to assess the dexamethasone delivery system for:

  • Safety and tolerability
  • Efficacy

Formal statistical analysis to compare treatment groups will not be performed due to the small number of participants in this pilot study. Summary statistics will be assessed using the short form of the knee injury and osteoarthritis outcome score (KOOS JR) surveys and questionnaires to assess pain intensity, pain medication consumption and wound assessment.

Who can participate

Healthy volunteers accepted: No

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

Inclusion criteria

  • Male or female ≥ 40 years of age at time of consent
  • Diagnosis of unilateral or bilateral knee osteoarthritis for at least 6 months prior to screening with confirmation of osteoarthritis according to the American College of Rheumatology Criteria for Classification of Idiopathic Osteoarthritis of the Knee (clinical and radiological) based on an X-ray performed within 6 months prior to screening or during the screening period
  • Kellgren - Lawrence grade ≥2 on weight bearing anteroposterior femorotibial radiograph performed within 6 months prior to or during screening period
  • Mean score of ≥ 5 and ≤ 10 on the 24 hour average pain score (0 - 10 Numeric Rating System) during the screening period
  • Body mass index (BMI) ≤ 40 kg/m2
  • Willingness and ability to comply with the study procedures and visit schedules and ability to follow verbal and written instructions
  • Willingness to stop all pain medications except acetaminophen and paracetamol 14 days prior to implantation

Exclusion criteria

  • Fibromyalgia, chronic pain syndrome, or other concurrent medical or arthritic conditions which could interfere with the evaluation of the index knee
  • History of inflammatory arthritis including rheumatoid arthritis, juvenile inflammatory arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, reactive arthritis
  • Hemophilia
  • Achondroplasia
  • History of infection in the index joint
  • Intra-articular corticosteroid (investigational or marketed) in any joint within three months of screening
  • Intra-articular hyaluronic acid (investigational or marketed) in the index knee within three months of screening
  • Oral, inhaled, and intranasal corticosteroids (investigational or marketed) within one month of screening
  • Prior arthroscopic or open surgery of the index knee within 12 months of screening
  • Planned / anticipated surgery of the index knee during the study period
  • Active or history of malignancy within the last five years, with the exception of resected basal cell carcinoma, squamous cell carcinoma of the skin, or resected cervical atypia or carcinoma in situ
  • Insulin dependent diabetes
  • History of or active Cushing's syndrome
  • Skin breakdown at index knee where procedure would take place
  • Women of child-bearing potential
  • Case history related to motor vehicle accident or workers compensation
  • Presence of hardware in the index knee (e.g. screws, plates)
  • Immunocompromised patients (TB, HIV, etc.)
  • Allergic reactions to acetaminophen and paracetamol

Treatment and study plan

Dexamethasone

Drug

Sustained delivery system containing 5.0 mg of dexamethasone programmed to release an estimated 10 μg per day

Primary outcomes

  1. Incidence of treatment emergent adverse events

    Time frame: Through 24 weeks

  2. Change from baseline in weekly mean of the pain intensity score

    Time frame: Weeks 12, 24

    Using a numeric rating scale for pain with a scale of 0 (no pain) to 10 (worst pain imaginable) at rest, during activity, and at night

Secondary outcomes

  1. Change from baseline in weekly mean of the pain intensity score

    Time frame: Weekly through 24 weeks

    Using a numeric rating scale for pain with a scale of 0 (no pain) to 10 (worst pain imaginable) at rest, during activity, and at night

  2. Time of onset of pain relief

    Time frame: Weekly through 24 weeks

  3. Change from baseline in KOOS-JR score (stiffness)

    Time frame: Over 1, 2, 4, 8, 12, 24 weeks post treatment

    Using a response scale of none, mild, moderate, severe, and extreme

  4. Change from baseline in KOOS-JR score (pain)

    Time frame: Over 1, 2, 4, 8, 12, 24 weeks post treatment

    Using a response scale of none, mild, moderate, severe, and extreme

  5. Change from baseline in KOOS-JR score (function)

    Time frame: Over 1, 2, 4, 8, 12, 24 weeks post treatment

    Using a response scale of none, mild, moderate, severe, and extreme

  6. Change in patient's global impression of scores assessed via office visits

    Time frame: Weeks 4, 12, 24

    Using a numeric rating scale for pain with a scale of 0 (no pain) to 10 (worst pain imaginable)

  7. Change in clinical observer's global impression of scores assessed via office visits

    Time frame: Weeks 4, 12, 24

    Using a numeric rating scale for pain with a scale of 0 (no pain) to 10 (worst pain imaginable)

  8. Percent of responders (defined as patients with high improvement in pain or function) according to OMERACT-OARSI criteria

    Time frame: Weeks 1, 2, 4, 8, 12, 24

  9. Average weekly consumption of rescue medications

    Time frame: Through 24 weeks

  10. Average total consumption of rescue medications

    Time frame: Through 24 weeks

Sponsors and collaborators

Lead sponsor

Mark Figgie

Other

Collaborators

  • Hospital for Special Surgery, New York

Registry information

Official study title

A Pilot Study of a Dexamethasone Implant System in Humans

Important dates

Study start
2016
Primary completion
2017
Study completion
2017
First posted
Aug 19, 2016
Registry last updated
Oct 1, 2018

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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