Clinical trial NCT00954629: A Study of the Efficacy and Safety of 2PX in Patients With Pain Due to Osteoarthritis of the Knee
Official title: A 26 Week Placebo-controlled, Randomised, Double-blind, Parallel Group Study of the Efficacy and Safety of 2PX (Topical Strontium Chloride Hexahydrate) in Patients With Pain Due to Osteoarthritis of the Knee
Study type: INTERVENTIONAL
Overall status: UNKNOWN
Phase: PHASE3
Conditions: Pain
Osteoarthritis
Keywords: Osteoarthritis
Pain
Knee
Lead sponsor: Smerud Medical Research International AS
Sponsor class: OTHER
Collaborators: name: SantoSolve AS
First posted: 2009-08-07
Enrollment: 300
Sex: ALL
Minimum age (years): 40
Standard ages: ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: TREATMENT

Brief summary: The purpose of the study is to demonstrate the superiority of topically administered 2PX versus placebo (vehicle) control in terms of reduction in pain intensity and physical function.

Detailed description: Primary objective: To demonstrate the superiority of topically administered 2PX versus placebo (vehicle) control in terms of reduction in pain intensity and physical function.

Secondary objectives: To prospectively measure other efficacy variables of topically administered 2PX in pain associated with osteoarthritis of the knee. To evaluate the safety and tolerability of topically administered 2PX.

Eligibility criteria: Inclusion Criteria:

* Male and female out-patients, 40 years or older.
* Subjects with documented OA of either one or both knees, as defined by the American College of Rheumatology (ACR) criteria (\[Altman R, Asch E, Bloch D, et al (1986)\]); i.e.knee pain and at least 3 out of the following 6 criteria in the target joint:

  * age \>50 years
  * stiffness \< 30 minutes
  * crepitus
  * bony tenderness
  * bony enlargement
  * no palpable warmth
* Radiological evidence of joint space narrowing in the target joint within 8 weeks prior to randomisation.
* Subjects with chronic, moderate to severe OA pain of the target knee:

  * present for more than 3 months, and for ≥ 20 days per month.
  * not controlled by, or intolerant of, oral NSAIDs, paracetamol, COX-2 inhibitors or weak opioids.
  * intensity at least moderate (i.e., actual WOMAC (pain questions 1-5) ≥ 10) on WOMAC OA index LK 3.1 at Visit 1, in the target knee, as recalled over the last 24 hours.

Exclusion Criteria:

* Subjects with any moderate to severe pain of other origin (e.g., fibromyalgia) which could confound assessment or self-evaluation of pain due to OA in the target knee.
* Subjects with any prosthesis fitted to the target knee.
* Subjects requiring treatment with any of the following agents/therapies within the specified periods or at any time during the study are excluded from participation:
* Any potent/strong opioid in the 4 weeks prior to randomisation (i.e., an opioid assumed to cause withdrawal symptoms upon abrupt discontinuation).
* Any topical or subcutaneously applied analgesic agents (e.g., capsaicin, NSAIDs) applied to the target knee within 7 days prior to randomisation.
* Any treatment which could alter the degree or nature of baseline OA pain planned within the study period.
* Intra-articular injections of corticosteroids in the target knee within the 2 months prior to randomisation.
* Intra-articular injections of hyaluronan in the target knee within 6 months prior to randomisation.
* Avascular necrosis in the target knee within 6 months prior to randomisation.
* Arthrosynthesis of the target knee within 12 months prior to randomisation.
* Arthroscopy of the target knee within 6 months prior to randomisation.
* Major trauma to the target knee within 6 months prior to randomisation.
* Infection in the target knee within 6 months prior to randomisation.
* Subjects who have previously been treated with 2PX.
* Subjects who have received an investigational drug or used an investigational device within the 30 days prior to randomisation.
* Subjects with a significant psychiatric disorder, in the opinion of the investigator, or subjects receiving strong anti-psychotic medication.
* Subjects with documented or suspected alcohol or drug abuse.
* Any ongoing or past history of malignant disease within the 5 years immediately prior to randomisation (with the exception of basal cell carcinoma).
* Pregnancy or ongoing lactation
* Female subjects of childbearing potential unwilling to use adequate contraceptive measures throughout the duration of the study. For the purpose of this study, adequate contraception is defined as:

  * oral, injected or implanted hormonal methods of contraception; OR
  * placement of an intrauterine device (IUD) or intrauterine system (IUS); OR
  * barrier methods of contraception: Condom or occlusive cap (diaphragm or cervical/vault caps) with spermicidal foam/gel/film/cream/suppository Note: Male sterilisation or abstinence are not acceptable methods of birth control and would preclude enrolment in the study.

Note: For post-menopausal women: less than 12 months since the last spontaneous menstrual bleeding will exclude the patient unless they are willing to utilise acceptable methods of contraception for the duration of the study.

* Male subjects able to conceive, who are unwilling to use barrier methods of contraception throughout the duration of the study
* Subjects unable to comply with the study assessments.

Primary outcomes:
measure: The difference between the active and placebo group in the change from Baseline to the assessment after 26 weeks of treatment in the actual WOMAC Osteoarthritis Index LK 3.1 subscale score for pain and physical function.
timeFrame: 26 weeks
Secondary outcomes:
measure: WOMAC Osteoarthritis Index LK 3.1; total and non-pain subscales:
timeFrame: At Screening, Baseline, Weeks 2, 4, 12, 26 and 27.
measure: Pain intensity will be assessed by asking the question 'What is the level of pain in your target knee right now?
timeFrame: Daily
measure: Patient Global Impression of Change (PGIC)
timeFrame: At weeks 12 and 26
measure: Clinician Global Impression of Change (CGIC)
timeFrame: At weeks 12 and 26
measure: Use of rescue medication: The number of paracetamol tablets used each day will be recorded.
timeFrame: Daily
measure: Incidence of Disease Flares: The number and extent of flares in osteoarthritis pain of the target knee between active and placebo groups during the course of treatment.
timeFrame: At weeks 2, 4, 12, 26, and 27
Other outcomes:
Locations:
city: Helsinki
country: Finland
facility: Site in Helsinki
city: Kuopio
country: Finland
facility: Site at Kuopio
city: Turku
country: Finland
facility: Site in Turku
city: Bialystok
country: Poland
facility: Site in Bialystok
city: Kraków
country: Poland
facility: Site in Kraków
city: Warszawa
country: Poland
facility: Site in Warszawa
city: St-Petersburg
country: Russian Federation
facility: Site in St-Petersburg
city: St-Petersburg
country: Russian Federation
facility: Site in St-Petersburg
city: Blackpool
country: United Kingdom
facility: Site in Blackpool
city: Bolton
country: United Kingdom
facility: Site in Bolton
city: Bradford
country: United Kingdom
facility: Site in Bradford
city: Manchester
country: United Kingdom
facility: Site in Manchester
city: Stockport
country: United Kingdom
facility: Site at Cheadle Hulme
city: Stockport
country: United Kingdom
facility: Site at Heald Green
city: Stockport
country: United Kingdom
facility: Site at Heaton Moor
Study officials:
affiliation: MAC Neuroscience centre in Blackpool, United Kingdom
name: Stuart Ratcliffe, MD
role: PRINCIPAL_INVESTIGATOR
References: