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Study of Intra-Articular ESBA105 Applied to Patients With Severely Painful Osteoarthritis of the Knee
This study is currently recruiting participants.
Verified by ESBATech AG, January 2009
Sponsored by: ESBATech AG
Information provided by: ESBATech AG
ClinicalTrials.gov Identifier: NCT00819572
  Purpose

The purpose of this study is to determine whether an intra-articular injection of ESBA105 to the knee joint of patients suffering from severly painful osteoarthritis is safe and reduces pain.


Condition Intervention Phase
Osteoarthritis
Biological: ESBA105, a single-chain (scFv) antibody against TNF-alpha
Drug: Placebo
Phase I
Phase II

MedlinePlus related topics: Osteoarthritis
Drug Information available for: Immunoglobulins Globulin, Immune Tumor Necrosis Factors
U.S. FDA Resources
Study Type: Interventional
Study Design: Treatment, Randomized, Double Blind (Subject, Caregiver, Investigator, Outcomes Assessor), Placebo Control, Parallel Assignment, Safety/Efficacy Study
Official Title: A Double-Blind, Randomised, Placebo-Controlled Phase I/IIa Study to Investigate the Safety, Tolerability and Efficacy on Pain of Intra-Articular ESBA105 Applied to Patients With Severely Painful Osteoarthritis of the Knee

Further study details as provided by ESBATech AG:

Primary Outcome Measures:
  • Change from Baseline (Day 0) to Day 7 in a 100mm Visual Analogue Scale (VAS) to assess the intensity of knee pain. [ Time Frame: Day 7 after intra-articular injection ] [ Designated as safety issue: No ]

Secondary Outcome Measures:
  • Change from baseline in Western Ontario and McMaster Universities Osteoarthritis (WOMAC™) scoring [ Time Frame: Day 7 after intra-articular injection ] [ Designated as safety issue: No ]

Estimated Enrollment: 126
Study Start Date: December 2008
Estimated Primary Completion Date: December 2009 (Final data collection date for primary outcome measure)
Arms Assigned Interventions
1: Experimental
ESBA105 low dose
Biological: ESBA105, a single-chain (scFv) antibody against TNF-alpha
Comparison of two different doses of intra-articular ESBA105
2: Experimental
ESBA105 high dose
Biological: ESBA105, a single-chain (scFv) antibody against TNF-alpha
Comparison of two different doses of intra-articular ESBA105
3: Placebo Comparator Drug: Placebo

Detailed Description:

Treatment options for patients suffering from osteoarthritis remain limited. TNF-alpha has been identified as a major pro-inflammatory component inducing and perpetuating peripheral hyperalgesia and cartilage degeneration in various preclinical studies. ESBA105 is an antibody fragment of comparably low molecular weight, associated with an exceptional local biodistribution pattern upon intra-articular injection. In addition, due to its short systemic half life as compared to conventional monoclonal antibodies, systemic exposure to ESBA105 upon intra-articular administration is low. This study is designed to determine the safety and local tolerability profile of single intra-articular injections of ESBA105 as well as to define ESBA105's effect size and effect duration in reducing pain of patients suffering from severely painful osteoarthritis of the knee. The study will be conducted in two sequential parts. In a first part, 4 different doses of ESBA105 will be compared in a sequential, escalating scheme against placebo treatment in a total of 24 patients. In the second part of the study, two doses of ESBA105 chosen based on safety data from the first part will be compared to placebo treatment in a total of 102 patients.

  Eligibility

Ages Eligible for Study:   40 Years and older
Genders Eligible for Study:   Both
Accepts Healthy Volunteers:   No
Criteria

Inclusion Criteria:

  • Body mass index < 30.
  • Patients with diagnosed OA of the knee (unilateral or bilateral) according to the American College of Rheumatology (ACR) Criteria for classification of idiopathic OA (clinical and radiological criteria) of the knee at Screening (for ACR criteria, see Appendix 16.1).
  • Radiographic evidence of tibiofemoral OA within the last 6 months before Screening, consisting of Grade II or Grade III changes, according to Kellgren-Lawrence grading system.
  • Presence of pain in the index knee (in case of bilateral OA, "index knee" is the more painful knee) defined by a level of > 60 mm on a 100 mm (linear) VAS at Screening.
  • Paracetamol and NSAIDs (apart from acetyl salicylic acid ≤ 100 mg/day) must be withdrawn at least 24 hours prior to Screening .
  • Doses of "chondroprotective" agents containing glucosamine and/or chondroitin sulphate must be stable for at least 3 months prior to Screening.
  • Doses of any non-prescription medication claiming effects on signs or symptoms of OA must be stable for at least 3 months prior to Screening.
  • Use of non-pharmacological treatment modalities must be stable for at least 3 months prior to Screening.
  • Negative QuantiFERON-TB Gold test.

Exclusion Criteria:

  • Radiographic evidence of tibiofemoral OA within the last 6 months before Screening, consisting of Grade IV, according to Kellgren-Lawrence grading system.
  • Instability of the index knee joint of > 10° as assessed by goniometer at Screening.
  • Arthroscopic or open surgery to the index knee joint within 6 months prior to Screening.
  • Post-traumatic or any other secondary OA of the knee.
  • Isolated OA of the patello-femoral joint.
  • Co-morbidity that would confound measurement of knee pain
  • Evidence of any inflammatory arthritis.
  • History of Reiter's Syndrome, RA, psoriatic arthritis, ankylosing spondylitis, lymphoma, arthritis associated with inflammatory bowel disease, sarcoidosis, amyloidosis, or any other inflammatory disease (immune mediated inflammatory disease) that may affect the knee.
  • Local or systemic contraindication for an i.a. injection at Screening or Baseline.
  • Any i.a. injection (corticosteroids, hyaluronic acid, etc.) within the 3 months prior to Screening.
  • History of high risk exposure to Mycobacterium tuberculosis.
  • Human immunodeficiency virus (HIV), hepatitis B or hepatitis C infection.
  • Uncontrolled diabetes or cardiovascular disease (New York Heart Association criteria III + IV), including uncontrolled hypertension (> 160/100 mmHg).
  • Active infectious episodes, or history of recurrent or chronic systemic infections.
  • Malignancy within 5 years prior to Screening, except for surgically-cured non melanoma skin cancer or cervical carcinoma in situ.
  • Significant haematological disease within 1 month prior to Screening.
  • Moderately to severely impaired hepatic function, or laboratory values reflecting inadequate hepatic function

Additional criteria for the sub-population of patients undergoing MRI:

  • Contraindications to MRI.
  • Known allergy to gadolinium contrast material.
  • Presence of chronic renal failure defined by a calculated creatinine clearance (CrCl) of < 60 mL/min, using the Cockcroft-Gault estimate for GFR
  Contacts and Locations
Please refer to this study by its ClinicalTrials.gov identifier: NCT00819572

Locations
Switzerland
Rheumatologische Universitäts-Poliklinik, Felix-Platter Spital Basel Recruiting
Basel, Switzerland, 4055
Contact: Ulrich Walker, MD         bettina.bannert@fps-basel.ch    
Principal Investigator: Ulrich Walker, MD            
Kantonsspital St.Gallen, Rheumatologie Recruiting
St.Gallen, Switzerland, 9007
Contact: Johannes von Kempis, MD         Ruediger.Mueller@kssg.ch    
Principal Investigator: Johannes von Kempis, MD            
Zentrum für Rheuma und Knochenerkrankungen Recruiting
Zurich, Switzerland, 8038
Contact: Hansjörg Häuselmann, MD         sekretariathjh@rheumazentrum.ch    
Switzerland, Aargau
Rheumaklinik Kantonsspital Aarau Recruiting
Aarau, Aargau, Switzerland, 5000
Contact: Paul Hasler, MD         Alexander.Iseli@ksa.ch    
Principal Investigator: Paul Hasler, MD            
Switzerland, Vaud
Service de rhumatologie, Centre Hospitalier Universitaire, Lausanne Recruiting
Lausanne, Vaud, Switzerland, 1005
Contact: Alexander KI So, MD         Daniele.Lorin-Belhoucine@chuv.ch    
Principal Investigator: Alexander KI So, MD            
Switzerland, Zurich
Universitätsspital Zürich, Rheumaklinik Recruiting
Zürich, Zurich, Switzerland, 8091
Contact: Diego Kyburz, MD         sandra.blumhardt@usz.ch    
Sponsors and Collaborators
ESBATech AG
Investigators
Study Chair: Georg Schett, MD University Hospital of Erlangen, Germany
Principal Investigator: Hansjörg Häuselmann, MD Rheumazentrum, Zurich Switzerland
Principal Investigator: Diego Kyburz, MD University Hospital Zurich, Switzerland
  More Information

Responsible Party: ESBATech AG ( Peter Lichtlen, Medical Director )
Study ID Numbers: ESBA105CRD02
Study First Received: January 8, 2009
Last Updated: January 8, 2009
ClinicalTrials.gov Identifier: NCT00819572  
Health Authority: Switzerland: Swissmedic;   Switzerland: Ethikkommission

Keywords provided by ESBATech AG:
Osteoarthritis
TNF-alpha
ESBA105
scFv antibody
pain

Study placed in the following topic categories:
Osteoarthritis, Knee
Antibodies
Musculoskeletal Diseases
Osteoarthritis
Joint Diseases
Arthritis
Pain
Rheumatic Diseases
Immunoglobulins

Additional relevant MeSH terms:
Immunologic Factors
Physiological Effects of Drugs
Pharmacologic Actions

ClinicalTrials.gov processed this record on January 16, 2009