A Study to Evaluate the Clinical Performance and Safety of an Intra-articular Hyaluronic Acid in Knee Osteoarthritis

• Register: ClinicalTrials.gov
• Last refreshed on: 29 November 2021
• Main ID: NCT03200288
• Date of registration: 21/06/2017
• Prospective Registration: Yes
• Primary sponsor: IBSA Institut Biochimique SA
• Public title: A Study to Evaluate the Clinical Performance and Safety of an Intra-articular Hyaluronic Acid in Knee Osteoarthritis
• Scientific title: A Phase 3,Randomized,Double-blind,Placebo-controlled Study to Evaluate the Clinical Performance and Safety of an Intra-articular Solution of High and Low Molecular Weight Hyaluronic Acid (HL-01) in the Treatment of Pain in Symptomatic Knee Osteoarthritis
• Date of first enrolment: June 29, 2017
• Target sample size: 692
• Recruitment status: Completed
• URL: https://clinicaltrials.gov/show/NCT03200288
• Study type: Interventional
• Study design: Allocation: Randomized. Intervention model: Parallel Assignment. Primary purpose: Treatment. Masking: Quadruple (Participant, Care Provider, Investigator, Outcomes Assessor).
• Phase: Phase 3

Countries of recruitment

Belgium, Germany, Hungary, Italy, Poland

Key inclusion & exclusion criteria

Inclusion Criteria:

- Female and male subjects =40 to 80 years of age.

- Subjects with primary knee OA of the medial or lateral femoro-tibial compartment,
documented according to ACR criteria with symptoms, at screening, from at least 3
months.

- Subjects with Kellgren & Lawrence (K-L) radiological grade 2-3.

- Subjects with at least one antero-posterior view X-Ray image of the target knee taken
within 12 months prior to the screening.

- Subjects with OA pain intensity meeting the criteria below:

If unilateral knee OA: Subjects demonstrating at screening pain intensity in the target
knee measured by Visual Analogue Scale (VAS) =40 mm VAS, and = 20 mm in the contralateral
knee and confirmed at randomization after wash-out from analgesics/NSAIDs.

If bilateral knee OA: definition of the most symptomatic joint at screening based on
subject's evaluation and Investigator's clinical judgment with subjects demonstrating pain
intensity in the target knee measured by Visual Analogue Scale (VAS) =40 mm VAS, and = 20mm
in the contralateral knee and confirmed at randomization after wash-out from
analgesics/NSAIDs.

- Subjects are able to understand and are willing and able to comply with study
procedures including usage of acetaminophen as the only analgesic.

- Subjects are able to provide informed consent.

- Any female subject of childbearing potential must agree to use adequate methods of
contraception throughout the course of the study.

Exclusion Criteria:

- Subjects with secondary (post-traumatic) knee OA of the target and non-target joints.

- Subjects with K-L radiological grade 4 knee OA.

- Subjects with a history of knee joint replacement/arthroplasty of the target knee.

- Subjects with a history of arthroscopy, osteotomy, or surgery of the target knee in
the past 12 months.

- Subjects with any significant injury to the target knee in the last 6 months (as per
Investigator judgment).

- Subjects with Body Mass Index (BMI) =32 kg/m2.

- Subjects with any musculoskeletal condition affecting the target knee that would
impair proper assessment of the Investigational Medicinal Device (IMD) performance in
the target knee as assessed by the Investigator and such as:

1. severe varus/valgus deformity (>15°)

2. predominantly patello-femoral pain/syndrome.

- Subjects with a history of symptomatic hip OA or other health condition i.e.
associated with pain and interfering with adequate study endpoints evaluation.

- Subjects with a known history or present evidence of conditions which may affect the
target knee assessments, like rheumatic disease and inflammatory, infective or
metabolic joint diseases; recurrent clinical chondrocalcinosis; crystal arthropathies;
osteo-articular pathologies differing from arthrosis; articular fracture; ochronosis;
acromegaly; haemochromatosis; Wilson's disease; primary osteochondromatosis; heritable
disorders; collagen gene mutations.

- Subjects with venous or lymphatic stasis in the relevant limb.

- Subjects with a history of the following treatments for knee OA:

a) I. a. knee corticosteroids: i. target knee - in the past 3 months ii. non-target
knee/other joints - in the past 4 weeks b) Systemic (both oral and parenteral) and
topical corticosteroids at the target knee in the past 3 months.

c) Topical anti-inflammatories and analgesics applied at the target knee in the past
48 hrs.

d) Viscosupplementation with hyaluronic acid or joint-lavage in the target knee in the
past year.

e) Physical therapy started in the last 3 months in the target knee. f) Symptomatic
Slow-Acting Drugs for OA (SYSADOA) such as glucosamine, chondroitin sulfate,
diacerhein, or other medications like avocado/soya extracts, etc. in the past 3
months.

g) Chronic or recurrent use of narcotic analgesics. h) Use of analgesic (other than
acetaminophen) and NSAIDs for a time of 5-half-lives before the screening.

- Subjects with a history of chronic or recurrent use of NSAIDs/analgesics/narcotics
because of diseases different from OA of the target knee.

- Subjects treated with drugs having an influence on pain: hypnotics, muscle relaxants,
anxiolytics if the intake has started less than 8 days before the screening.

- Subjects who currently use heparin or anti-vitamin K (e. g. crystalline warfarin)
anticoagulant therapy.

- Subjects with the presence of infection, skin diseases, other disease or trauma in the
area of the injection site or joint.

- Subjects with a known history or suspected allergy or hypersensitivity to hyaluronic
acid or to hyaluronate preparations.

- Subjects with a known history or suspected allergy or hypersensitivity to
acetaminophen.

- Subjects with any major surgery scheduled in the next 6 months.

- Subjects who have participated in a clinical study / investigation in the last 3
months.

- Pregnant or lactating women and women of childbearing potential not willing to use
adequate contraception.



Age minimum: 40 Years
Age maximum: 80 Years
Gender: All

Health Condition(s) or Problem(s) studied

Knee Osteoarthritis

Intervention(s)

Device: HL-01: high and low molecular weight hyaluronic acid

Device: Placebo

Primary Outcome(s)

Change in VAS (Visual Analogue Scale) pain score [Time Frame: Baseline-week 24]

Secondary Outcome(s)

Change in global status assessed by physician [Time Frame: Baseline -Week 24]

Rescue medication usage [Time Frame: Week 6-Week 24]

Overall response rate according to OMERACT (Outcome Measures in Rheumatology)-OARSI (Osteoarthritis Research Society International) criteria [Time Frame: Week 6-Week 24]

Change in global status assessed by subject (EQ-5D-5L EuroQol Group Health questionnaire) [Time Frame: Baseline-Week 24]

Change in Lequesne's Algofunctional Index [Time Frame: Baseline-Week 24]

Secondary ID(s)

16EU-Hai13

Source(s) of Monetary Support

Please refer to primary and secondary sponsors