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This is a multi-center, randomized, open-label, parallel-arm phase IV clinical study, for which a total of 300 patients with mild to moderate knee osteoarthritis will be enrolled. In the first 4 weeks (run-in period), the subjects will receive on-demand treatment with Diclofenac Sodium Sustained Release Tablets (DICL-SR) 75mg, quaque die(QD). After the run-in period, the subjects, if their knee pain has not worsened to a level requiring surgical treatment, will be randomized to two groups in 1:1 ratio: one group receiving Artz® via intra-articular injection (once weekly, for 5 consecutive weeks) in combination with DICL-SR 75mg,quaque die(QD), for 12 consecutive weeks on demand. The other group receiving DICL-SR 75mg alone,quaque die(QD), for 12 consecutive weeks on demand. DICL-SR 75mg quaque die(QD) may be administered to the subjects of both groups on demand as long as they have a knee pain. If the knee pain has disappeared, this drug may be withdrawn. However, if the pain occurs again and requires treatment, oral administration of DICL-SR may be resumed. A subject is allowed to withdraw from this study prematurely if unable to tolerate the adverse effects.
A total of 8 visits have been scheduled for this study, including Visit 1/screening period (Week -4), Visit 2/baseline (Week 0), Visit 3 (Week 1), Visit 4 (Week 2), Visit 5 (Week 3), Visit 6 (Week 4), Visit 7 (Week 8) and Visit 8 (Week 12).
A total of 300 subjects will participate in this study at 6 to 8 centers in China, and patient enrollment is expected to take up to 12 months.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Sodium Hyaluronate Injection + DICL-SR | Experimental | Each syringe (2.5mL) contains 25mg of sodium hyaluronate, and one Artz® will be administered via intra-articular injection into the target knee at the baseline and Weeks 1, 2, 3 and 4 respectively for the combination group. From the run-in period to the end of study, both groups will receive DICL-SR 75mg, which is administered on demand for treatment of knee pain. If the knee pain is relieved or has disappeared, DICL-SR may be withdrawn. However, if the pain occurs again and requires treatment, the drug may be resumed. If a dose of 75mg daily fails to control the knee pain, it may be increased to the maximum dose 150mg daily upon the approval of the investigator, that is, 75mg bis in die(BID) daily |
|
| DICL-SR | Active Comparator | From the run-in period to the end of study, both groups will receive Diclofenac Sodium Sustained-release Tablets(DICL-SR) 75mg, which is administered on demand for treatment of knee pain. If the knee pain is relieved or has disappeared, DICL-SR may be withdrawn. However, if the pain occurs again and requires treatment, the drug may be resumed. If a dose of 75mg daily fails to control the knee pain, it may be increased to the maximum dose 150mg daily upon the approval of the investigator, that is, 75mg bis in die(BID daily). A subject is allowed to withdraw from this study prematurely if unable to tolerate the adverse effects. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Sodium Hyaluronate Injection | Drug |
| ||
| DICL-SR |
| Measure | Description | Time Frame |
|---|---|---|
| Compare the average daily doses (unit: pills) of the NSAID from Week9 (W9) to W12 between two groups | From W9 to W12 (4 weeks) |
| Measure | Description | Time Frame |
|---|---|---|
| Compare the average daily doses (unit: pills) of the NSAID from W5 to W8, and W5 to W12 between two groups | From W5 to W8 (4 weeks), and W5 to W12 (8 weeks) | |
| Compare the changes in the average daily doses (unit: pills) of the NSAID at the 8th and 12th week from baseline between two groups. |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of all adverse events (AEs) and serious adverse events (SAEs) | up to 16 weeks |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| YA NAN TANG, Master | Contact | +86-21-33278388 | 211 | annie_tyn@163.com |
| Kun Zheng WANG, Doctor | Contact | +86-29-87678326 | wkzh1955@163.com |
| Name | Affiliation | Role |
|---|---|---|
| Kun Zheng WANG, Doctor | Second Affiliated Hospital of Xi'an Jiaotong University | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Peking Union Medical College Hospital | Active, not recruiting | Beijing | Beijing Municipality | 100730 | China | |
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| ID | Term |
|---|---|
| D020370 | Osteoarthritis, Knee |
| ID | Term |
|---|---|
| D010003 | Osteoarthritis |
| D001168 | Arthritis |
| D007592 | Joint Diseases |
| D009140 | Musculoskeletal Diseases |
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| ID | Term |
|---|---|
| D006820 | Hyaluronic Acid |
| ID | Term |
|---|---|
| D006025 | Glycosaminoglycans |
| D011134 | Polysaccharides |
| D002241 | Carbohydrates |
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| Drug |
|
| At the 8th week from baseline (1 week), and at the 12th week from baseline (1 week) |
| Compare the percentage changes in the average daily doses (unit: pills) of the NSAID at the 8th and 12th week from baseline between two groups. | At the 8th week from baseline (1 week), and at the 12th week from baseline (1 week) |
| Compare the days of NSAID consumption from W5 to W8, W9 to W12, and W5 to W12 between two groups. | From W5 to W8 (4 weeks), W9 to W12 (4 weeks), and W5 to W12 (8 weeks) |
| Compare the changes in WOMAC A1 score (walk-associated pain), WOMAC A, B and C score and patient global assessment (PTGA) at the 4th, 8th and 12th week from baseline between two groups. | At the 4th week from baseline (1 week), at the 8th week from baseline (1 week), and at the 12th week from baseline (1 week) |
| Compare the changes in clinical observer global assessment (COGA), and scores for activities of daily living (ADL) at the 4th, 8th and 12th week from baseline between two groups. | At the 4th week from baseline (1 week), at the 8th week from baseline (1 week), and at the 12th week from baseline (1 week) |
| The First Affiliated Hospital of Chongqing Medical University |
| Not yet recruiting |
| Chongqing |
| Chongqing Municipality |
| 400016 |
| China |
|
| Nanfang Hospital | Recruiting | Guangzhou | Guangdong | 510515 | China |
|
| Nanjing Drum Tower Hospital | Not yet recruiting | Nanjing | Jiangsu | 210008 | China |
|
| The Second Affiliated Hospital of Xi'an Jiaotong University | Recruiting | Xi'an | Shaanxi | 409099 | China |
|
| Shanghai 6th People's Hospital | Not yet recruiting | Shanghai | Shanghai Municipality | 200235 | China |
|
| D012216 |
| Rheumatic Diseases |