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Safety and Efficacy of XT-150 for Facet Joint Osteoarthritis Pain

A Placebo-controlled, Double-blind Evaluation of Safety, Tolerability, and Efficacy of XT- 150 for the Treatment of Facet Joint Osteoarthritis Pain

Status
Completed
Phases
Phase 2
Study type
Interventional
Source
ClinicalTrials.gov
Registry ID
NCT05196919
Enrollment
75
Registered
2022-01-19
Start date
2022-02-24
Completion date
2023-09-20
Last updated
2025-01-15

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

Back Pain, Facet Joint Pain, Inflammation

Keywords

FJOA, Facetogenic Pain, Intra-articular Injection

Brief summary

This is a Phase 2a safety and efficacy study of XT-150 in adult participants experiencing back pain due to inflammation of the facet joint, also known as facet joint osteoarthritis (FJOA), and who are eligible for intra articular glucocorticoid injection, or radiofrequency ablation of medial branches of the primary dorsal ramus of the exiting nerve root, which innervates the adjacent facet joints. Study drug will be administered at Day 0 and Day 90 by bilateral intra-articular (IA) injection into the facet capsule, at the affected spinal level (e.g. Lumbar \[L\]3-4, L4-5, or L5-Sacrum \[S\]1) as determined by imaging (e.g., Magnetic resonance imaging \[MRI\], Computed tomography \[CT\]), X-ray, etc.) and physical exam. Up to 72 participants will be randomized to placebo or one of two dose treatment groups (24 participants per treatment group). 1. 0.15 mg XT-150 (1.0 milliliter \[mL\] total delivered by two 0.5 mL injections) 2. 0.45 mg XT-150 (1.0 mL total delivered by two 0.5 mL injections) 3. Placebo (Sterile saline) (1.0 mL total delivered by two 0.5 mL injections)

Interventions

BIOLOGICALXT-150

XT-150 is a plasmid Deoxyribonucleic acid (DNA) formulated in buffered, D mannose saline solution.

BIOLOGICALPlacebo

Phosphate-buffered saline for injection

Sponsors

Xalud Therapeutics, Inc.
Lead SponsorINDUSTRY

Study design

Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)

Masking description

Placebo controlled, double blind

Eligibility

Sex/Gender
ALL
Age
18 Years to 90 Years
Healthy volunteers
No

Inclusion criteria

Participants are required to meet ALL of the following inclusion criteria: 1. Male or female, between 18 and 90 years of age, inclusive. 2. Sufficiently severe facet arthropathy of lumbar facets as determined by imaging (e.g., MRI, CT, X-ray, etc.) to establish an underlying basis of disease, as determined by usual bony and ligamentous signs of osteoarthritis (OA). Use of historical images permitted if obtained within the last 12 months. 3. Complaint of nociceptive, mechanical pain of lumbar spine, in particular pain localized to paramedian axis as opposed to midline or radicular. Radicular pain as a secondary finding may be allowed if it is in addition to mechanical pain and can be clinically distinguished by participant. 4. LBP (Low Back Pain) worsened by activity or motion of region 5. Have had a positive diagnostic facet pain block with lidocaine; admittance if participant gains 50% relief of pain within 30 minutes of test injection 6. Be free of local or intra-articular infection, tumor or other causes of localized LBP, for example, spondylolysis/pars defect, and adjacent vertebral body compression fracture based on imaging evaluation. 7. Symptomatic disease because of osteoarthritis, established by imaging of facet joint and defined as a worst pain of at least 50 at the Screening Visit and the Baseline (Day 0) Visit (based on scale of 0 to 100, with 100 representing pain as bad as you can imagine) using Visual Analog Scale (VAS). 8. Stable analgesic regimen during the 4 weeks prior to enrollment. Participants who are not currently on any analgesics at the time of enrollment because they have discontinued prior analgesic therapy due to intolerance or lack of effect may be included. New analgesics or changes to the pre-established regimen during the study, with the exception of rescue medication use, are not permitted. 9. Inadequate pain relief with prior therapies lasting 3 months or more. 10. In the judgment of the Investigator, acceptable general medical condition 11. Heterosexually active participants, male and female who are not surgically sterile or post-menopausal, must agree to use effective contraception, including abstinence, for the duration of the study and for 3 months after the study is completed 12. Have suitable facet joint anatomy for intra-articular injection 13. Willing and able to return for the follow-up (FU) visits 14. Able to read and understand study instructions, and willing and able to comply with all study procedures

Exclusion criteria

Participants must NOT meet any of the following

Design outcomes

Primary

MeasureTime frameDescription
Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsUp to Day 270Adverse events were collected from the time of informed consent through the last study visit on Day 270 (9 months). Treatment Emergent Adverse Events (TEAEs) occurred from the time of study drug treatment on Day 0 through end of study (Day 270) or early termination.
Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsUp to Day 270Hematology and chemistry samples were only collected at Screening and not retested; therefore no results are available for those assessments Abnormal clinically significant physical examination findings were reported as adverse events, as applicable, and not separately reported. Vital signs of temperature, heart rate, respiratory rate and blood pressure were collected at all visits throughout the study.
Change From Baseline in Pain Intensity Using 0-100 Visual Analog Scale (VAS)Day 270The VAS is 0-100 scale which will be administered to participants via Electronic Patient Reported Outcome (ePRO) at each study visit. The participant will record his/her facet pain level on a scale from 0 (no pain) to 100 (worst pain). Higher scores indicate worse pain intensity.

Secondary

MeasureTime frameDescription
Change From Baseline in Oswestry Disability Index (ODI) ScoresDay 270The Oswestry Disability Index (ODI) is a 10-item questionnaire to quantify disability for acute or chronic low back pain. Each question is scored on a scale of 0 (least amount of disability) to 5 (most severe disability). Higher scores indicate severe disability.
Change From Baseline in Patient Global Assessment (PGA) ScoresUp to Day 270PGA is used to assess the current disease state on a 5-point Likert scale (1 = very good; 2 = good; 3 = fair; 4 = poor; and 5 = very poor). Higher score indicates worse symptoms.
Change From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) ScoresDay 270The globally standardized and validated IPAQ - short form is used to measure self-reported physical activity levels. Four metabolic equivalent tasks (MET) - vigorous, moderate, walking and sitting were included to obtain the physical activity levels from the participants. A higher MET value indicates a higher physical activity level.

Countries

United States

Participant flow

Participants by arm

ArmCount
0.15mg XT-150
0.15mg XT-150 administered in 1.0 mL total delivered by two 0.5 mL injections on Day 0 and Day 90. XT-150: XT-150 is a plasmid Deoxyribonucleic acid (DNA) formulated in buffered, D mannose saline solution.
25
0.45mg XT-150
0.45mg XT-150 administered in 1.0 mL total delivered by two 0.5 mL injections on Day 0 and Day 90. XT-150: XT-150 is a plasmid Deoxyribonucleic acid (DNA) formulated in buffered, D mannose saline solution.
25
Placebo
Placebo administered in 1.0 mL total delivered by two 0.5 mL injections on Day 0 and Day 90. Placebo: Phosphate-buffered saline for injection
25
Total75

Baseline characteristics

Characteristic0.15mg XT-1500.45mg XT-150PlaceboTotal
Age, Continuous59.5 years
STANDARD_DEVIATION 9.71
58.0 years
STANDARD_DEVIATION 13.11
63.6 years
STANDARD_DEVIATION 13.74
60.3 years
STANDARD_DEVIATION 12.37
Body Mass Index (BMI)31.0 kg/m2
STANDARD_DEVIATION 6.23
31.0 kg/m2
STANDARD_DEVIATION 6.77
27.7 kg/m2
STANDARD_DEVIATION 6.44
29.9 kg/m2
STANDARD_DEVIATION 6.59
Ethnicity (NIH/OMB)
Hispanic or Latino
0 Participants3 Participants3 Participants6 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
25 Participants22 Participants22 Participants69 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants0 Participants1 Participants1 Participants
Race (NIH/OMB)
Asian
1 Participants0 Participants1 Participants2 Participants
Race (NIH/OMB)
Black or African American
4 Participants4 Participants3 Participants11 Participants
Race (NIH/OMB)
More than one race
1 Participants0 Participants0 Participants1 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants0 Participants0 Participants0 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants0 Participants1 Participants1 Participants
Race (NIH/OMB)
White
19 Participants21 Participants19 Participants59 Participants
Region of Enrollment
United States
25 participants25 participants25 participants75 participants
Sex: Female, Male
Female
13 Participants8 Participants13 Participants34 Participants
Sex: Female, Male
Male
12 Participants17 Participants12 Participants41 Participants

Adverse events

Event typeEG000
affected / at risk
EG001
affected / at risk
EG002
affected / at risk
deaths
Total, all-cause mortality
0 / 250 / 250 / 25
other
Total, other adverse events
11 / 2512 / 2514 / 25
serious
Total, serious adverse events
1 / 251 / 250 / 25

Outcome results

Primary

Change From Baseline in Pain Intensity Using 0-100 Visual Analog Scale (VAS)

The VAS is 0-100 scale which will be administered to participants via Electronic Patient Reported Outcome (ePRO) at each study visit. The participant will record his/her facet pain level on a scale from 0 (no pain) to 100 (worst pain). Higher scores indicate worse pain intensity.

Time frame: Day 270

Population: Intent to Treat (ITT) population: All participants who were randomized who received the treatment injection analyzed according to randomized treatment. This was a phase 2a safety study that was not statistically powered for efficacy assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.15mg XT-150Change From Baseline in Pain Intensity Using 0-100 Visual Analog Scale (VAS)-38.12 score on a scaleStandard Error 6.432
0.45mg XT-150Change From Baseline in Pain Intensity Using 0-100 Visual Analog Scale (VAS)-34.37 score on a scaleStandard Error 5.717
PlaceboChange From Baseline in Pain Intensity Using 0-100 Visual Analog Scale (VAS)-42.32 score on a scaleStandard Error 5.811
Comparison: This was a phase 2a safety study that was not statistically powered for efficacy assessments.p-value: 195% CI: [-22.57, 30.97]Mixed Models Analysis
Comparison: This was a phase 2a safety study that was not statistically powered for efficacy assessments.p-value: 0.9995% CI: [-17.12, 33.03]Mixed Models Analysis
Primary

Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital Signs

Hematology and chemistry samples were only collected at Screening and not retested; therefore no results are available for those assessments Abnormal clinically significant physical examination findings were reported as adverse events, as applicable, and not separately reported. Vital signs of temperature, heart rate, respiratory rate and blood pressure were collected at all visits throughout the study.

Time frame: Up to Day 270

Population: Safety population

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
0.15mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Normal22 Participants
0.15mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Abnormal - Not Clinically Significant3 Participants
0.15mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Abnormal Clinically Significant0 Participants
0.15mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Not Analyzed (Missing Data)0 Participants
0.15mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Normal15 Participants
0.15mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Abnormal - Not Clinically Significant0 Participants
0.15mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Abnormal Clinically Significant0 Participants
0.15mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Not Analyzed (Missing Data)10 Participants
0.45mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Abnormal Clinically Significant0 Participants
0.45mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Abnormal Clinically Significant0 Participants
0.45mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Not Analyzed (Missing Data)0 Participants
0.45mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Normal19 Participants
0.45mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Abnormal - Not Clinically Significant1 Participants
0.45mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Normal24 Participants
0.45mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Abnormal - Not Clinically Significant1 Participants
0.45mg XT-150Number of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Not Analyzed (Missing Data)5 Participants
PlaceboNumber of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Abnormal Clinically Significant0 Participants
PlaceboNumber of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Abnormal - Not Clinically Significant2 Participants
PlaceboNumber of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Normal23 Participants
PlaceboNumber of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 0Not Analyzed (Missing Data)0 Participants
PlaceboNumber of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Abnormal Clinically Significant0 Participants
PlaceboNumber of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Abnormal - Not Clinically Significant0 Participants
PlaceboNumber of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Normal20 Participants
PlaceboNumber of Participants Reporting Abnormal Hematology and Chemistry Parameters, Physical Examination, and Vital SignsDay 270Not Analyzed (Missing Data)5 Participants
Primary

Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEs

Adverse events were collected from the time of informed consent through the last study visit on Day 270 (9 months). Treatment Emergent Adverse Events (TEAEs) occurred from the time of study drug treatment on Day 0 through end of study (Day 270) or early termination.

Time frame: Up to Day 270

Population: Safety population

ArmMeasureGroupCategoryValue (COUNT_OF_PARTICIPANTS)
0.15mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated Serious TEAEsNo25 Participants
0.15mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsAny TEAEsYes11 Participants
0.15mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated Serious TEAEsYes0 Participants
0.15mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated TEAEsYes1 Participants
0.15mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsAny TEAEsNo14 Participants
0.15mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated TEAEsNo24 Participants
0.15mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsSerious TEAEsYes1 Participants
0.15mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsSerious TEAEsNo24 Participants
0.45mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsSerious TEAEsYes1 Participants
0.45mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsSerious TEAEsNo24 Participants
0.45mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsAny TEAEsNo13 Participants
0.45mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated TEAEsYes1 Participants
0.45mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated Serious TEAEsYes0 Participants
0.45mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsAny TEAEsYes12 Participants
0.45mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated Serious TEAEsNo25 Participants
0.45mg XT-150Number of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated TEAEsNo24 Participants
PlaceboNumber of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated Serious TEAEsNo25 Participants
PlaceboNumber of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated TEAEsYes3 Participants
PlaceboNumber of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsAny TEAEsYes14 Participants
PlaceboNumber of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated TEAEsNo22 Participants
PlaceboNumber of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsSerious TEAEsYes0 Participants
PlaceboNumber of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsSerious TEAEsNo25 Participants
PlaceboNumber of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsRelated Serious TEAEsYes0 Participants
PlaceboNumber of Participants Reporting Serious Adverse Events (SAEs) and Non-SAEsAny TEAEsNo11 Participants
Secondary

Change From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) Scores

The globally standardized and validated IPAQ - short form is used to measure self-reported physical activity levels. Four metabolic equivalent tasks (MET) - vigorous, moderate, walking and sitting were included to obtain the physical activity levels from the participants. A higher MET value indicates a higher physical activity level.

Time frame: Day 270

Population: Intent to Treat (ITT) population: All participants who were randomized who received the treatment injection analyzed according to randomized treatment. This was a phase 2a safety study that was not statistically powered for efficacy assessments.

ArmMeasureGroupValue (MEAN)Dispersion
0.15mg XT-150Change From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) ScoresDays moderate physical activity during last 7 days1.5 daysStandard Deviation 3.44
0.15mg XT-150Change From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) ScoresDays vigorous physical activity during last 7 days0.7 daysStandard Deviation 2.43
0.15mg XT-150Change From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) ScoresDays walking at least 10 minutes during last 7 days0.9 daysStandard Deviation 2.64
0.45mg XT-150Change From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) ScoresDays moderate physical activity during last 7 days-0.6 daysStandard Deviation 3.45
0.45mg XT-150Change From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) ScoresDays vigorous physical activity during last 7 days-0.6 daysStandard Deviation 1.64
0.45mg XT-150Change From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) ScoresDays walking at least 10 minutes during last 7 days-0.8 daysStandard Deviation 3.07
PlaceboChange From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) ScoresDays vigorous physical activity during last 7 days-0.3 daysStandard Deviation 1.06
PlaceboChange From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) ScoresDays walking at least 10 minutes during last 7 days-0.5 daysStandard Deviation 3.27
PlaceboChange From Baseline in International Physical Activity Questionnaire (IPAQ Short Form) ScoresDays moderate physical activity during last 7 days0.2 daysStandard Deviation 3.08
Secondary

Change From Baseline in Oswestry Disability Index (ODI) Scores

The Oswestry Disability Index (ODI) is a 10-item questionnaire to quantify disability for acute or chronic low back pain. Each question is scored on a scale of 0 (least amount of disability) to 5 (most severe disability). Higher scores indicate severe disability.

Time frame: Day 270

Population: Intent to Treat (ITT) population: All participants who were randomized who received the treatment injection analyzed according to randomized treatment. This was a phase 2a safety study that was not statistically powered for efficacy assessments.

ArmMeasureValue (LEAST_SQUARES_MEAN)Dispersion
0.15mg XT-150Change From Baseline in Oswestry Disability Index (ODI) Scores-14.4 score on a scaleStandard Error 3.43
0.45mg XT-150Change From Baseline in Oswestry Disability Index (ODI) Scores-3.11 score on a scaleStandard Error 3.104
PlaceboChange From Baseline in Oswestry Disability Index (ODI) Scores-8.25 score on a scaleStandard Error 3.17
Comparison: This was a phase 2a safety study that was not statistically powered for efficacy assessments.p-value: 0.193395% CI: [-15.49, 3.19]Mixed Models Analysis
Comparison: This was a phase 2a safety study that was not statistically powered for efficacy assessments.p-value: 0.251195% CI: [-3.73, 14]Mixed Models Analysis
Secondary

Change From Baseline in Patient Global Assessment (PGA) Scores

PGA is used to assess the current disease state on a 5-point Likert scale (1 = very good; 2 = good; 3 = fair; 4 = poor; and 5 = very poor). Higher score indicates worse symptoms.

Time frame: Up to Day 270

Population: Intent to Treat (ITT) population: All participants who were randomized who received the treatment injection analyzed according to randomized treatment. This was a phase 2a safety study that was not statistically powered for efficacy assessments.

ArmMeasureValue (MEAN)Dispersion
0.15mg XT-150Change From Baseline in Patient Global Assessment (PGA) Scores-0.6 score on a scaleStandard Deviation 1.55
0.45mg XT-150Change From Baseline in Patient Global Assessment (PGA) Scores-0.7 score on a scaleStandard Deviation 1.18
PlaceboChange From Baseline in Patient Global Assessment (PGA) Scores-0.9 score on a scaleStandard Deviation 0.97

Source: ClinicalTrials.gov · Data processed: Feb 4, 2026