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The objectives of this study were to characterize the local extent and duration of exposure of TA from FX006 and TCA IR, characterize the systemic PK of FX006 and TCA IR, and assess the safety and general tolerability of a single 5 mL IA injection of 32 mg FX006 relative to 40 mg of TCA IR in patients with OA of the knee.
This study employed an open-label, single administration design and was conducted in male and female patients ≥40 years of age with OA of the knee.
Patients were enrolled sequentially with at least 10 patients per cohort as follows:
Cohort A: FX006 32 mg, Final Visit at Week 20 Cohort B: FX006 32 mg, Final Visit at Week 16 Cohort C: FX006 32 mg, Final Visit at Week 12 Cohort D: FX006 32 mg, Final Visit at Week 6 Cohort E: FX006 32 mg, Final Visit at Week 1 Cohort F: TCA IR 40 mg, Final Visit Week 6
Each patient was screened to confirm eligibility and assigned to a cohort on Day 1/baseline. Each patient was evaluated for safety during his/her participation in the study at 6, 12, 16, or 20 weeks following a single IA injection depending on the assigned Cohort, and plasma and synovial fluid was collected for drug concentration measurements.
Safety and tolerability was assessed by physical examinations, index knee examinations, vital signs, clinical laboratory evaluations, and adverse events (AEs).
No efficacy assessments were employed in this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| FX006 32 mg | Experimental | Single 5 mL intra-articular (IA) injection Extended-release formulation |
|
| TCA IR 40 mg | Active Comparator | Commercially available triamcinolone acetonide, single 1 mL intra-articular (IA) injection Immediate-release formulation |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| FX006 32 mg | Drug | Single 5 mL IA injection |
|
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| Measure | Description | Time Frame |
|---|---|---|
| Synovial Fluid Drug Concentrations (pg/mL) by Time Point Pooled Across FX006 Cohorts and TCA IR in Synovial Fluid | All baseline (pre-treatment) values and all post-baseline values recorded as below LLOQ (<50 pg/mL) were set to zero. Geometric mean summary statistics were computed on adjusted concentration values. One (1) was added to each concentration value observed. BLQ values for the computation of geometric mean are included in the summary with a value of 1 (0+1). | Up to 20 Weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Plasma Drug Concentrations (pg/mL) by Time Pooled Across FX006 Cohorts and TCA IR 40 mg Cohort | All baseline (pre-treatment) values and all post-baseline values that are recorded as below LLOQ were set to zero for analysis and were included in the descriptive mean calculations. Values below LLOQ were not included in geometric mean calculations. | Up to 20 Weeks |
| Measure | Description | Time Frame |
|---|---|---|
| Plasma Pharmacokinetic Parameters for FX006 and TCA IR | Up to 20 Weeks |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Neil Bodick, MD | Flexion Therapeutics | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Canoga Park | California | 91303 | United States | |||
Patients were enrolled sequentially with at least 10 patients per Cohort. Subjects were enrolled within 14 days of Screening.
Patients were screened for study eligibility at four (4) study centers in the United States (US).
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| ID | Title | Description |
|---|---|---|
| FG000 | FX006 32 mg | 63 subjects received FX006 32 mg as a single 5 mL IA injection |
| FG001 | TCA IR 40 mg | 18 subjects received TCA IR 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 32 mg | Single 5 mL IA injection |
| BG001 | TCA IR 40 mg | Single 1 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 | Synovial Fluid Drug Concentrations (pg/mL) by Time Point Pooled Across FX006 Cohorts and TCA IR in Synovial Fluid | All baseline (pre-treatment) values and all post-baseline values recorded as below LLOQ (<50 pg/mL) were set to zero. Geometric mean summary statistics were computed on adjusted concentration values. One (1) was added to each concentration value observed. BLQ values for the computation of geometric mean are included in the summary with a value of 1 (0+1). | All patients who received study drug and had synovial fluid obtained at the Synovial Fluid Visit and assayed for drug concentration levels. | Posted | Geometric Mean | 95% Confidence Interval | pg/mL | Up to 20 Weeks |
|
Adverse Events were collected following IA administration on Baseline/Day 1 up to 20 weeks.
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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 32 mg | Single 5 mL intra-articular injection FX006: Sustained Release Steroid |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Pulmonary Embolism | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
| Term | Organ System | Source Vocabulary | Assessment Type | Notes | Statistical Information |
|---|---|---|---|---|---|
| Nasopharyngitis | Infections and infestations | MedDRA | Systematic Assessment |
Subsequent to completion of clinical studies extensive testing was performed to assess the actual FX006 dose delivered. It was determined that the FX006 delivered dose to the patient from an FX006 40 mg vial is 32 mg.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Scott Kelley, VP of Medical Affairs | Flexion Therapeutics | 781-305-7142 | skelley@flexiontherapeutics.com |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| D010003 | Osteoarthritis |
| D010146 | Pain |
| ID | Term |
|---|---|
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
| D012216 | Rheumatic Diseases |
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| ID | Term |
|---|---|
| C000631825 | FX006 |
| D014221 | Triamcinolone |
| ID | Term |
|---|---|
| D011245 | Pregnadienes |
| D011278 | Pregnanes |
| D013256 | Steroids |
| D000072473 | Fused-Ring Compounds |
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| TCA IR 40 | Drug | Single 1 mL IA injection |
|
|
| San Diego |
| California |
| 92103 |
| United States |
| Hialeah | Florida | 33012 | United States |
| Duncansville | Pennsylvania | 16635 | United States |
| BG002 |
| Total |
Total of all reporting groups |
| years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| TCA IR 40 mg |
Single 1 mL IA injection |
|
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| Secondary | Plasma Drug Concentrations (pg/mL) by Time Pooled Across FX006 Cohorts and TCA IR 40 mg Cohort | All baseline (pre-treatment) values and all post-baseline values that are recorded as below LLOQ were set to zero for analysis and were included in the descriptive mean calculations. Values below LLOQ were not included in geometric mean calculations. | All patients who received study drug and had at least one post-baseline plasma sample obtained and assayed for drug concentration levels. | Posted | Geometric Mean | 95% Confidence Interval | pg/mL | Up to 20 Weeks |
|
|
|
| Other Pre-specified | Plasma Pharmacokinetic Parameters for FX006 and TCA IR | Not Posted | Up to 20 Weeks | Participants |
| 0 |
| 63 |
| 1 |
| 63 |
| 7 |
| 63 |
| EG001 | TCA IR 40 mg | Commercially available triamcinolone acetonide, single 1 mL intra-articular injection TCA IR: Immediate Release Steroid | 0 | 18 | 0 | 18 | 2 | 18 |
| Foot Fracture | Injury, poisoning and procedural complications | MedDRA | Systematic Assessment |
|
| Weight Increased | Investigations | MedDRA | Systematic Assessment |
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| Arthralgia | Musculoskeletal and connective tissue disorders | MedDRA | Systematic Assessment |
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| Patellofemoral Pain Syndrome | Musculoskeletal and connective tissue disorders | MedDRA | Systematic Assessment |
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| Pulmonary Embolism | Respiratory, thoracic and mediastinal disorders | MedDRA | Systematic Assessment |
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| Hypertension | Vascular disorders | MedDRA | Systematic Assessment |
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| Flushing | Vascular disorders | MedDRA | Systematic Assessment |
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| D009461 |
| Neurologic Manifestations |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D011083 |
| Polycyclic Compounds |
| D013259 | Steroids, Fluorinated |
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