Osteoarthritis, Knee
Conditions
Brief summary
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.
Detailed description
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.
Interventions
DRUGDexamethasone
Sustained delivery system containing 5.0 mg of dexamethasone programmed to release an estimated 10 μg per day
Sponsors
Hospital for Special Surgery, New York
Mark Figgie
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Age
40 Years to 99 Years
Healthy volunteers
No
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
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Incidence of treatment emergent adverse events | Through 24 weeks | — |
| Change from baseline in weekly mean of the pain intensity score | 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
| Measure | Time frame | Description |
|---|---|---|
| Change from baseline in KOOS-JR score (stiffness) | Over 1, 2, 4, 8, 12, 24 weeks post treatment | Using a response scale of none, mild, moderate, severe, and extreme |
| Change from baseline in KOOS-JR score (pain) | Over 1, 2, 4, 8, 12, 24 weeks post treatment | Using a response scale of none, mild, moderate, severe, and extreme |
| Change from baseline in KOOS-JR score (function) | Over 1, 2, 4, 8, 12, 24 weeks post treatment | Using a response scale of none, mild, moderate, severe, and extreme |
| Change in patient's global impression of scores assessed via office visits | Weeks 4, 12, 24 | Using a numeric rating scale for pain with a scale of 0 (no pain) to 10 (worst pain imaginable) |
| Change from baseline in weekly mean of the pain intensity score | 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 |
| Percent of responders (defined as patients with high improvement in pain or function) according to OMERACT-OARSI criteria | Weeks 1, 2, 4, 8, 12, 24 | — |
| Average weekly consumption of rescue medications | Through 24 weeks | — |
| Average total consumption of rescue medications | Through 24 weeks | — |
| Change in clinical observer's global impression of scores assessed via office visits | Weeks 4, 12, 24 | Using a numeric rating scale for pain with a scale of 0 (no pain) to 10 (worst pain imaginable) |
| Time of onset of pain relief | Weekly through 24 weeks | — |
Countries
United States
Outcome results
None listed