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The purpose of this study was to evaluate the safety, pharmacokinetics and pharmacodynamics of FX006 in patients with osteoarthritis of the knee.
This study was a double-blind, randomized, parallel-group, active comparator design. The study was conducted in male and female patients ≥35 years of age with symptomatic OA of the knee.
Twenty-four (24) patients with knee OA were randomized (1:1:1:1) and treated with a single IA injection of either 10, 40, or 60 mg of FX006 or 40 mg of TCA IR.
Each patient was evaluated for a total of 6 weeks following a single IA injection. Following screening, safety, PK and pharmacodynamics (PD) were evaluated during one (1) 48-hour in-patient period (Day -1 to Day 2), two (2) 24-hour in-patient periods (Day 14-15 and Day 42-43) and seven (7) out-patient visits (Days 3, 4, 5, 8, 22, 29 and 36).
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| FX006 10mg | Experimental | Single 3 mL intra-articular (IA) injection Extended-release formulation |
|
| FX006 40mg | Experimental | Single 3 mL intra-articular (IA) injection Extended-release formulation |
|
| FX006 60 mg | Experimental | Single 3 mL intra-articular (IA) injection Extended-release formulation |
|
| TCA IR (40 mg) | Active Comparator | Single 1 mL intra-articular (IA) injection Immediate-release formulation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FX006 10 mg | Drug | single 3 mL IA injection |
| |
| FX006 40 mg |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in 24-hour Weighted Mean Serum Cortisol | The primary pharmacodynamic endpoint was change from baseline (pre-dose) to Day 1-2, Day 14-15 (Week 2) and Day 42-43 (Week 6) in 24-hour weighted mean serum cortisol. This is defined as AUC over the 0-24 hour measurement period divided by 24 | Days 1-2, Days 14-15 (Week 2) and Days 42-43 (Week 6) |
| Characterize the Pharmacokinetic Profile of FX006 and TCA IR | Concentrations below the limit of quantification of 50 pg/mL were treated as 0. | Day 1 (1, 2, 4, 6, 8, 12 and 24 hours post dose) and Days 3, 4, 5, 8, 15, 22, 29, 36 and 43 |
| Measure | Description | Time Frame |
|---|---|---|
| Change From Baseline in 24-hour Urinary Free Cortisol Excretion | Baseline to Days 1-2, Baseline to Days 14-15 (Week 2) and Baseline to Days 42-43 (Week 6) | |
| Total 24-hour Urinary Free Cortisol Excretion | Days 1-2, Days 14-15 (Week 2) and Days 42-43 (Week 6) |
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Main Inclusion Criteria:
Main Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Neil Bodick, MD | Flexion Therapeutics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Adelaide | South Australia | 5000 | Australia | |||
Subjects were screened for eligibility within 14 days of being randomized
This study took place at 2 centers, both located in Australia. Enrollment for this study took approximately 1.5 months.
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| ID | Title | Description |
|---|---|---|
| FG000 | FX006 10mg | 5 subjects received FX006 10 mg as a single 3 mL IA injection. |
| FG001 | FX006 40mg | 7 subjects received FX006 40 mg as a single 3 mL IA injection. |
| FG002 | FX006 60 mg | 7 subjects received FX006 60 mg as a single 3 mL IA injection. |
| FG003 | TCA IR 40 mg | 5 subjects received commercially available triamcinolone acetonide (40 mg) as a single 1 mL IA injection. |
| Title | Milestones | Reasons Not Completed | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
|
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| ID | Title | Description |
|---|---|---|
| BG000 | FX006 10mg | Single 3 mL IA injection |
| BG001 | FX006 40mg | Single 3 mL IA injection |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Continuous | Mean |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Change From Baseline in 24-hour Weighted Mean Serum Cortisol | The primary pharmacodynamic endpoint was change from baseline (pre-dose) to Day 1-2, Day 14-15 (Week 2) and Day 42-43 (Week 6) in 24-hour weighted mean serum cortisol. This is defined as AUC over the 0-24 hour measurement period divided by 24 | Posted | Least Squares Mean | 95% Confidence Interval | weighted mean serum cortisol (nmol/L) | Days 1-2, Days 14-15 (Week 2) and Days 42-43 (Week 6) |
|
Adverse Events were collected from post injection on Day 1 through Day 43.
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | FX006 10mg | Single 3 mL IA injection | 0 |
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| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Palpitations | Cardiac disorders | MedDRA | Systematic Assessment |
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| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Scott Kelley, Chief Medical Officer | Flexion Therapeutics | 781-305-7142 | skelley@flexiontherapeutics.com |
| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D010003 | Osteoarthritis |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| ID | Term |
|---|---|
| C000631825 | FX006 |
| D014222 | Triamcinolone Acetonide |
| ID | Term |
|---|---|
| D014221 | Triamcinolone |
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 |
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| Drug |
single 3 mL IA injection |
|
| FX006 60 mg | Drug | single 3 mL IA injection |
|
| TCA IR 40 | Drug | single 1 mL IA injection |
|
|
| Change From Baseline to Each Measured Time Point Post-dose in Morning Serum Cortisol | Least square mean difference against TCA IR 40 mg | Baseline to Days 2, 3, 4, 5, 8, 14, 15, 22, 29, 36, 42 and 43 |
| Perth |
| Western Australia |
| Australia |
| BG002 |
| FX006 60 mg |
Single 3 mL IA injection |
| BG003 | TCA IR (40 mg) | Single 1 mL IA injection |
| BG004 | Total | Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| FX006 60 mg |
Single 3 mL IA injection |
| OG003 | TCA IR 40 mg | Single 1 mL IA injection |
|
|
| Primary | Characterize the Pharmacokinetic Profile of FX006 and TCA IR | Concentrations below the limit of quantification of 50 pg/mL were treated as 0. | PK population was to include all patients who received study drug and had at least one measurable concentration | Posted | Geometric Mean | Standard Deviation | pg/mL | Day 1 (1, 2, 4, 6, 8, 12 and 24 hours post dose) and Days 3, 4, 5, 8, 15, 22, 29, 36 and 43 |
|
|
|
| Secondary | Change From Baseline in 24-hour Urinary Free Cortisol Excretion | Full Analysis Set (FAS) includes all observations from all patients who received a dose of study drug and provided a baseline observation and at least one post baseline observation. | Posted | Least Squares Mean | 95% Confidence Interval | nmol/24h | Baseline to Days 1-2, Baseline to Days 14-15 (Week 2) and Baseline to Days 42-43 (Week 6) |
|
|
|
| Secondary | Total 24-hour Urinary Free Cortisol Excretion | FAS includes all observations from all patients who received a dose of study drug and provided a baseline observation and at least one post baseline observation. | Posted | Geometric Mean | Standard Deviation | nmol/24h | Days 1-2, Days 14-15 (Week 2) and Days 42-43 (Week 6) |
|
|
|
| Secondary | Change From Baseline to Each Measured Time Point Post-dose in Morning Serum Cortisol | Least square mean difference against TCA IR 40 mg | The full analysis set will include all observations from all patients who received any dose of FX006 and provide a baseline observation and at least one post baseline observation. | Posted | Least Squares Mean | 95% Confidence Interval | nmol/L | Baseline to Days 2, 3, 4, 5, 8, 14, 15, 22, 29, 36, 42 and 43 |
|
|
|
| 5 |
| 0 |
| 5 |
| 4 |
| 5 |
| EG001 | FX006 40mg | Single 3 mL IA injection | 0 | 7 | 0 | 7 | 7 | 7 |
| EG002 | FX006 60 mg | Single 3 mL IA injection | 0 | 7 | 0 | 7 | 6 | 7 |
| EG003 | TCA IR 40 mg | Single 1 mL IA injection of commercially available triamcinolone acetonide | 0 | 5 | 0 | 5 | 5 | 5 |
| Dental caries | Gastrointestinal disorders | MedDRA | Systematic Assessment |
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| Diarrhoea | Gastrointestinal disorders | MedDRA | Systematic Assessment |
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| Nausea | Gastrointestinal disorders | MedDRA | Systematic Assessment |
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| Vomiting | Gastrointestinal disorders | MedDRA | Systematic Assessment |
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| Adverse drug reaction | General disorders | MedDRA | Systematic Assessment |
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| Catheter site haematoma | General disorders | MedDRA | Systematic Assessment |
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| Catheter site related reaction | General disorders | MedDRA | Systematic Assessment |
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| Feeling hot | General disorders | MedDRA | Systematic Assessment |
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| Injection site erythema | General disorders | MedDRA | Systematic Assessment |
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| Injection site pain | General disorders | MedDRA | Systematic Assessment |
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| Vessel puncture site haematoma | General disorders | MedDRA | Systematic Assessment |
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| Nasopharyngitis | Infections and infestations | MedDRA | Systematic Assessment |
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| Sinusitis | Infections and infestations | MedDRA | Systematic Assessment |
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| Upper respiratory tract infection | Infections and infestations | MedDRA | Systematic Assessment |
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| Contusion | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
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| Joint injury | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
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| Joint sprain | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
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| Laceration | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
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| Post-traumatic pain | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
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| Blood pressure increased | Investigations | MedDRA | Systematic Assessment |
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| Diabetes mellitus | Metabolism and nutrition disorders | MedDRA | Systematic Assessment |
|
| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA | Systematic Assessment |
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| Arthropathy | Musculoskeletal and connective tissue disorders | MedDRA | Systematic Assessment |
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| Joint stiffness | Musculoskeletal and connective tissue disorders | MedDRA | Systematic Assessment |
|
| Muscle spasms | Musculoskeletal and connective tissue disorders | MedDRA | Systematic Assessment |
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| Musculoskeletal Pain | Musculoskeletal and connective tissue disorders | MedDRA | Systematic Assessment |
|
| Myalgia | Musculoskeletal and connective tissue disorders | MedDRA | Systematic Assessment |
|
| Spinal osteoarthritis | Musculoskeletal and connective tissue disorders | MedDRA | Systematic Assessment |
|
| Dizziness | Nervous system disorders | MedDRA | Systematic Assessment |
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| Headache | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Lethargy | Nervous system disorders | MedDRA | Systematic Assessment |
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| Syncope | Nervous system disorders | MedDRA | Systematic Assessment |
|
| Anxiety | Psychiatric disorders | MedDRA | Systematic Assessment |
|
| Insomnia | Psychiatric disorders | MedDRA | Systematic Assessment |
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| Libido decreased | Psychiatric disorders | MedDRA | Systematic Assessment |
|
| Cough | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
|
| Oropharyngeal pain | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
|
| Wheezing | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
|
| Night Sweats | Skin and subcutaneous tissue disorders | MedDRA | Systematic Assessment |
|
| Pruritus | Skin and subcutaneous tissue disorders | MedDRA | Systematic Assessment |
|
| Flushing | Vascular disorders | MedDRA | Systematic Assessment |
|
| Hypertension | Vascular disorders | MedDRA | Systematic Assessment |
|
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| Fused-Ring Compounds |
| D011083 | Polycyclic Compounds |
| D013259 | Steroids, Fluorinated |
| 2 hours postdose |
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| 4 hours postdose |
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| 6 hours postdose |
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| 8 hours postdose |
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| 12 hours postdose |
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| Day 2 (24 hrs post dose) |
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| Day 3 (48 hrs post dose) |
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| Day 4 (72 hrs post dose) |
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| Day 5 (96 hrs post dose) |
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| Day 8 (168 hrs post dose) |
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| Day 15 (336 hrs post dose) |
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| Day 22 (504 hrs post dose) |
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| Day 29 (672 hrs post dose) |
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| Day 36 (840 hrs post dose) |
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| Day 43 (1008 hrs post dose) |
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| Day 14 to 15 |
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| Day 42 to 43 |
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| Day 14 to 15 |
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| Day 42 to 43 |
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| Day 3 |
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| Day 4 |
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| Day 5 |
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| Day 8 |
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| Day 14 |
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| Day 15 |
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| Day 22 |
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| Day 29 |
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| Day 36 |
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| Day 42 |
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| Day 43 |
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