AP-003-C Study to Confirm the Efficacy of Ampion™ in Adults With Pain Due to Severe Osteoarthritis of the Knee

• Sponsor: Ampio Pharmaceuticals. Inc.
• Information provided by (Responsible Party): Ampio Pharmaceuticals. Inc.

Study Description

Brief Summary:

This is a phase 3 randomized study to confirm the efficacy of an intra-articular injection of Ampion™ in adults with pain due to severe osteoarthritis of the knee.

There will be a 7-day screening period for each subject followed by a 12-week participation period.

The primary trial objective is to evaluate the clinical efficacy of Ampion using the OMERACT-OARSI (using the WOMAC 3.1 Index and PGA as assessments).

The secondary trial objectives are to evaluate the safety of a single intra-articular injection (4 mL) of Ampion.

Condition or disease	Intervention/treatment	Phase
Osteoarthritis, Knee; Knee Osteoarthritis; Knee Arthritis; Knee Pain Chronic	Biological: Ampion; Other: Saline	Phase 3

Study Design

• Study Type: Interventional (Clinical Trial)
• Actual Enrollment: 168 participants
• Allocation: Randomized
• Intervention Model: Parallel Assignment
• Masking: Double (Participant, Investigator)
• Primary Purpose: Treatment
• Official Title: A Phase 3 Randomized Study to Confirm the Efficacy of an Intra-Articular Injection of Ampion™ in Adults With Pain Due to Severe Osteoarthritis of the Knee
• Actual Study Start Date: June 19, 2017
• Actual Primary Completion Date: December 5, 2017
• Actual Study Completion Date: December 7, 2017

Arms and Interventions

Arm	Intervention/treatment
Experimental: Ampion; Ampion (<5 kilodalton (kDa) ultrafiltrate of 5% Human Serum Albumin (HSA)), solution, 4 mL, single intra-articular injection	Biological: Ampion; Ampion (<5 kilodalton (kDa) ultrafiltrate of 5% HSA)
Saline; Saline, solution, 4 mL, single intra-articular injection	Other: Saline; 0.9% sodium chloride

Outcome Measures

Primary Outcome Measures :

1. Evaluate responder status using OMERACT-OARSI using WOMAC A subscore, WOMAC C subscore, and PGA as composite endpoints [ Time Frame: Week 12 ]

   A patient in this study will be considered a responder for the purpose of efficacy analysis if the following criteria is met.

   1. The patient has a percent improvement in pain (WOMAC A) of ≥50% and an absolute change in pain from baseline of ≥ 1 point on the 5-point Likert scale or the patient has a percent improvement in function (WOMAC C) ≥50% and an absolute change in function from baseline of ≥1 point on the 5-point Likert scale.

      If the patient does not meet this criterion, then

   2. The patient demonstrates improvement in at least 2 of the following:

      • Improvement in pain (WOMAC A) ≥20% and a 0.5 point absolute change in pain from Baseline on the 5-point Likert scale
      • Improvement in function (WOMAC C) ≥20% and a 0.5 point absolute change in function from Baseline on the 5-point Likert scale
      • Improvement in patient global assessment (PGA) ≥20% and a 0.5 point absolute change in PGA from Baseline on the 5-point Likert scale

Secondary Outcome Measures :

1. Evaluate improvement of the composite endpoint of WOMAC A and WOMAC C [ Time Frame: Week 12 ]
   Evaluate improvement in the composite endpoint of pain and function (WOMAC A and C) from Baseline to Week 12
2. Evaluate improvement in PGA [ Time Frame: Week 12 ]
   Evaluate improvement in PGA from Baseline to Week 12
3. Evaluate improvement in the composite endpoint of pain and function (WOMAC A and C) compared to saline from all single-injection Ampion studies [ Time Frame: Week 12 ]
   Evaluate improvement in the composite endpoint of pain and function (WOMAC A and C) compared to saline from all single-injection Ampion studies from Baseline to Week 12

Eligibility Criteria

• Ages Eligible for Study: 40 Years to 85 Years (Adult, Older Adult)
• Sexes Eligible for Study: All
• Accepts Healthy Volunteers: No

Criteria

Inclusion Criteria:

• Able to provide written informed consent to participate in the study;
• Willing and able to comply with all study requirements and instructions of the site study staff;
• Must be ambulatory;
• Study knee must have a clinical diagnosis of osteoarthritis (OA) supported by radiological evidence (Kellgren Lawrence Grade 4) which is assessed locally (x-rays within the past 6 months of screening are acceptable);
• Moderate to moderately-severe OA pain in the study knee (rating of at least 1.5 on the WOMAC A, 5-point Likert Pain Subscale);
• Moderate to moderately-severe OA function in the study knee (rating of at least 1.5 on the WOMAC C, 5-point Likert Function Subscale);
• WOMAC A, 5-point Likert pain subscale <1.5 in the contralateral knee;
• Ability to discontinue non-steroidal anti-inflammatory drug (NSAID) use at Screening visit and/or 72 hours prior to the Baseline visit and for the duration of the clinical study (low-dose aspirin (81 mg) is allowed during the study);
• No analgesia (including acetaminophen) taken 24 hours prior to an efficacy measure;
• No known clinically significant liver abnormality (e.g. cirrhosis, transplant, etc.).

Exclusion Criteria:

• As a result of medical review and screening investigation, the Principal Investigator considers the subject unfit for the study
• A history of allergic reactions to human albumin (reaction to non-human albumin such as egg albumin is not an exclusion criterion)
• A history of allergic reactions to excipients in 5% human albumin (N-acetyltryptophan, sodium caprylate)
• Presence of tense effusions
• Inflammatory or crystal arthropathies, acute fractures, history of aseptic necrosis or joint replacement in the affected knee, as assessed locally by the Principal Investigator
• Isolated patella femoral syndrome, also known as chondromalacia
• Any other disease or condition interfering with the free use and evaluation of the study knee for the duration of the trial (e.g. cancer, congenital defects, spine osteoarthritis)
• Major injury to the study knee within the 12 months prior to screening
• Severe hip osteoarthritis ipsilateral to the study knee
• Any pain that could interfere with the assessment of study knee pain (e.g. pain in any other part of the lower extremities, pain radiating to the knee)
• Any pharmacological or non-pharmacological treatment targeting OA started or changed during the 4 weeks prior to randomization or likely to be changed during the duration of the study
• Pregnancy or planning to become pregnant during the study

• Use of the following medications:

  1. No intra-articular (IA) injected medications in the study knee during the study (or 12 weeks prior to Baseline).
  2. No analgesics containing opioids.
  3. NSAIDs are not permitted during the study; acetaminophen is available as a rescue medication during the study from the provided supply.
  4. No topical treatment on the study knee during the study
  5. No significant anticoagulant therapy (e.g. Heparin or Lovenox) during the study (treatment such as low-dose Aspirin (81 mg) and Plavix are allowed)
  6. No systemic treatments that may interfere with safety or efficacy assessments during the study
  7. No immunosuppressants
  8. No use of systemic or intra-articular corticosteroids
• No human albumin treatment in the 3 months before randomization or throughout the duration of the study

Contacts and Locations

Locations

United States, Alabama

Central Research Associates, Inc.

Birmingham, Alabama, United States, 35205

United States, California

CORE Orthopaedic Medical Center

Encinitas, California, United States, 92024

St. Joseph Heritage

Fullerton, California, United States, 92835

Artemis Institute for Clinical Research

San Diego, California, United States, 92103

Westlake Medical Research

Thousand Oaks, California, United States, 91360

United States, Georgia

Drug Studies America

Marietta, Georgia, United States, 30060

United States, Illinois

Healthcare Research Netword

Blue Island, Illinois, United States, 60406

United States, Kansas

Heartland Research Associates

Wichita, Kansas, United States, 67207

United States, Maryland

Arthritis Treatment Center

Frederick, Maryland, United States, 21702

United States, Missouri

Healthcare Network Research

Hazelwood, Missouri, United States, 63042

United States, South Carolina

Coastal Carolina Center at Lowcountry Orthopaedics

North Charleston, South Carolina, United States, 29406

United States, Texas

Tekton Research

Austin, Texas, United States, 78745

United States, Washington

Northwest Clinical Research Center

Bellevue, Washington, United States, 98007

Sponsors and Collaborators

Ampio Pharmaceuticals. Inc.

Investigators

• Study Director: David Bar-Or, MD; Ampio Pharmaceuticals. Inc.
• Study Director: Holly Mitzel; Ampio Pharmaceuticals. Inc.

More Information

Publications automatically indexed to this study by ClinicalTrials.gov Identifier (NCT Number):

Salottolo K, Cole B, Bar-Or D. Intra-articular injection of the anti-inflammatory compound LMWF-5A in adults with severe osteoarthritis: a double-blind prospective randomized controlled multi-center safety and efficacy trial. Patient Saf Surg. 2018 Jun 18;12:11. doi: 10.1186/s13037-018-0158-0. eCollection 2018.

• Responsible Party: Ampio Pharmaceuticals. Inc.
• ClinicalTrials.gov Identifier: NCT03182686 History of Changes
• Other Study ID Numbers: AP-003-C
• First Posted: June 9, 2017
• Last Update Posted: June 20, 2019
• Last Verified: June 2019

Individual Participant Data (IPD) Sharing Statement:

• Plan to Share IPD: No

• Studies a U.S. FDA-regulated Drug Product: Yes
• Studies a U.S. FDA-regulated Device Product: No

Keywords provided by Ampio Pharmaceuticals. Inc.:

osteoarthritis; osteoarthritis of the knee; OA; OAK; Kellgren Lawrence (KL)

Additional relevant MeSH terms:

Osteoarthritis; Osteoarthritis, Knee; Arthritis; Joint Diseases; Musculoskeletal Diseases; Rheumatic Diseases