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Osteoarthritis of the Lumbar SpinePhase 3NCT03110523

A Study to Evaluate the Efficacy and Safety of X0002 Spray in Subjects With Osteoarthritis of the Lumbar Spine

A Phase 3 study testing X0002 in people with Osteoarthritis of the Lumbar Spine and Pain, Back, run by Techfields Pharma Co. Ltd.

Withdrawn

Withdrawn. The study stopped before anyone enrolled.

Official record
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Trial summary

This is a Phase 3, Multicenter, Randomized, 22 Week, Double-Blind, Placebo Controlled and 3-Week, Open-Label Study to Evaluate the Efficacy and Safety of X0002 Spray in relief of the signs and symptoms of Subjects with Osteoarthritis of the Lumbar Spine. Read more about this study

Who is it for?
Ages 35 to 85 years
What is being tested?
X0002
Could I receive a placebo?
No, everyone receives an active treatment
How many people
0 participants
Where
No sites listed yet
Study dates
30 Mar 2023to 30 Jul 2025
Phase
Phase 3
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 35 to 85 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Must be able to read and to provide written, personally signed, and dated informed consent to participate in the study, in accordance with the ICH GCP Guideline E6 and applicable regulations, before completing any study related procedures.
  • Has an understanding, ability, and willingness to fully comply with study procedures and restrictions, as determined by the investigator.
  • Must be a male or female between 35 and 85 years of age, inclusive.
  • Must have a body mass index between 18.5 and 40.0 kg/m2, inclusive.
  • Must have a history (documented diagnosis) of clinically symptomatic OA of the lumbar spine for ≥3 months at Screening.
  • Must have a Lane Radiographic Grading Scale summary score for lumbar spine OA (levels L1 through L5) of 1 or 2 as determined by a central radiologist at Screening.
Show all 14Show fewer
  • Must have had low back pain while standing, walking, and/or on motion for at least 14 days during the month prior to Screening per subject self-report documented by the investigator.
  • Must have a score ≥4 and ≤9 on a 0 to 10 (11 point) NPRS (without analgesic medication other than rescue medication provided by the Sponsor) over the previous 7 days prior to Baseline (Day 1).
  • Must have an ODI score ≥40% and ≤90 % at Screening Visit and Baseline (Day 1).
  • With the exception of OA of the lumbar spine, must be in good general health with no clinically significant findings from medical history, vital signs, physical examination, ECG, and routine laboratory tests that could interfere with subject safety, pain or functional assessments, as determined by the investigator.
  • Female subjects must either not be of childbearing potential defined as 1) postmenopausal for at least 1 year; follicle stimulating hormone [FSH] must be in postmenopausal range for the central lab if used to confirm postmenopausal status in a woman not using estrogen replacement therapy OR 2) surgically sterile [i.e., bilateral tubal ligation, bilateral oophorectomy, or hysterectomy]) or be willing to practice abstinence or at least 1 of the following medically acceptable methods of birth control:
  • Hormonal methods such as oral, implantable, injectable, vaginal ring, or transdermal contraceptives for a minimum of 1 full cycle (based on the subject's usual menstrual cycle period) before study drug administration;
  • Intrauterine device;
  • Double-barrier method (condoms, sponge, or diaphragm with spermicidal jellies or cream).

Who cannot join

  • 1. Not willing to avoid unaccustomed, strenuous physical activity (e.g., starting a new weight lifting routine) for the duration of the study starting at Screening Visit and through their completion of participation in the study. Normal physical activity is allowed.
  • Has an active or pending workman's compensation claim or litigation related to back pain.
  • Has secondary OA of the low back or OA of lower limb joints that, in the opinion of the investigator, could interfere with pain and functional assessments related to the low back.
  • Has a history of spinal surgery.
  • Has more than 25% improvement from Numeric Pain Rating Scale (NPRS) score at the Screening visit to the average NPRS score over the previous 7 days prior to Day 1.
  • Has had significant injury, as judged by the investigator, involving the back within the 6 months before Screening.
Show all 39Show fewer
  • Has been diagnosed with or has signs and symptoms of a radiculopathy, e.g., numbness or tingling in a dermatomal distribution of a lower limb, sciatica, as well as etiologies of low back pain other than OA.
  • Has skin lesions or wounds on or near the lumbar spine area to be treated at Screening or on Day 1, which may influence absorption of the medication or confound safety assessments per the investigator's opinion.
  • Has used gabapentin, pregabalin, antiepileptics, or specific antidepressants (i.e., tricyclics, serotonin norepinephrine reuptake inhibitors, or selective serotonin reuptake inhibitors) to treat pain in the 14 days before Screening. Other uses not related to the pain treatment may be permitted at the medical monitor's discretion provided they have been at a stable dose for at least 90 days.
  • Has had injections of corticosteroids, botulinum toxin, or viscosupplements (e.g., Synvisc®) to the spine area (eg., intra articular [IA], epidural or paraspinal) within the 12 weeks before Screening.
  • Has had IA, intradiscal or intravenous (IV) stem cell therapy in the 6 months prior to Screening.
  • Has received concomitant non-pharmacologic treatments (e.g., physiotherapy, acupuncture) that per investigator opinion could confound efficacy assessments within 14 days of Day 1.
  • Is not willing to discontinue any NSAIDs or other analgesics (i.e., acetaminophen other than rescue medication supplied by the Sponsor, and cyclooxygenase-2 [COX-2] inhibitors), other treatments such as cannabis, and any topical therapies (e.g., anesthetics, capsaicin) or potentially confounding concomitant nonpharmacologic treatments (e.g., physiotherapy, acupuncture) starting at Screening Visit until completing participation in the study (the use of ≤325 mg acetylsalicylic acid per day for cardiac prophylaxis is permitted).
  • Is not willing to discontinue applying any topical preparations containing Vitamin A acids (including all trans retinoic acid [tretinoin], 13 cis retinoic acid [isotretinoin], 9 cis retinoic acid [alitretinoin], Vitamin A [retinol], retinal, and their derivatives) to the low back starting at Screening Visit until completing participation in the study. Topical preparations containing Vitamin A acids or retinol may be applied to areas of the skin above the shoulders or to the lower extremities.
  • Has a history of significant hypersensitivity, intolerance, or allergy to ibuprofen, any other NSAIDs, aspirin, or acetaminophen.
  • Has used an anticoagulant or antiplatelet agent (except aspirin up to 325 mg/day for cardiac prophylaxis) in the 30 days prior to Screening.
  • Has had an active gastrointestinal (GI) ulceration in the 6 months prior to Screening or a history of GI bleeding within 5 years of Screening.
  • Has uncontrolled depression or other uncontrolled psychiatric disorder (subjects with controlled depression or other psychiatric disorder, if using medication, must be on a stable dose of a medication other than an epileptic, tricyclic, serotonin norepinephrine reuptake inhibitor, or selective reuptake inhibitor for ≥12 weeks prior to Screening to participate in the study).
  • Has positive results on fecal occult blood testing at Screening or on Day 1.
  • Has a documented history of chronic inflammatory disease (such as rheumatoid arthritis, ankylosing spondylitis, axial spondyloarthropathy, psoriatic arthritis, inflammatory bowel disease or gouty arthritis) or a chronic pain condition (such as fibromyalgia), or has other conditions that may affect the spine or the functional and pain assessments (e.g., diffuse idiopathic skeletal hyperostosis, spinal stenosis, osteoporosis, severe scoliosis [curvature >30 degrees], severe kyphosis or lordosis [curvature >50 degrees]).
  • Is an asthmatic requiring treatment with systemic corticosteroids in the last year. Asthmatic subjects using inhaled corticosteroids are eligible.
  • Has uncontrolled hypertension defined as systolic blood pressure >170 mmHg or diastolic blood pressure >90 mmHg at Baseline (may be repeated 1 additional time after 5 minutes rest to verify). The investigator may, at his discretion, choose to exclude subjects with blood pressure levels lower than these if he deems it in the best interest of the subject.
  • Is receiving systemic chemotherapy, has an active malignancy, lymphoproliferative disorder or blood dyscrasia of any type, or has been diagnosed with cancer within 5 years before Screening. Subjects with completely excised and healed squamous or basal cell carcinoma of the skin will be allowed.
  • Has had any osteoporosis treatments (e.g., bisphosphonates, denosumab, parathyroid hormone (PTH), strontium ranelate).
  • Has any other clinically significant unstable cardiovascular, respiratory, neurological, immunological, hematological, hepatic or renal disease, or any other condition that, in the investigator's opinion, could compromise the subject's welfare, ability to communicate with the study staff, or otherwise contraindicate study participation.
  • Has an abnormal clinical central laboratory assessment at Screening for any of the following:
  • Aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase or lactate dehydrogenase (LDH) ≥3 × the upper limit of normal [ULN]
  • Total bilirubin ≥1.5 × ULN
  • Creatinine ≥1.5 × ULN
  • Hemoglobin <10 g/dL
  • Has any other clinically significant central laboratory finding at Screening that in the investigator's opinion contraindicates study participation;
  • Has clinically significant abnormality on 12-lead ECG, including a QTcF interval >450 milliseconds for males and 470 msec for females.
  • Is pregnant, planning to become pregnant during the study, or lactating; for women of childbearing potential, serum and urine pregnancy test must be negative at Screening Visit and urine pregnancy test must be negative at Baseline (Day 1) for subject to be eligible to participate.
  • Has participated in a previous clinical study with X0002.
  • Has participated in any other investigational clinical trial within the past 30 days or 5 half-lives of the investigational drug, whichever is longer, prior to Screening.
  • Has known alcohol or other substance abuse in the investigator's opinion.
  • Is a participating investigator, sub-investigator, study coordinator, or employee of a participating investigator, or is an immediate family member of the aforementioned.
  • Has any factor, which in the opinion of the investigator would jeopardize the evaluation or safety or be associated with poor adherence to the protocol.
  • Does not have access to telephone and/or ability to gain technology access.

About this study

Official title: A Phase 3, Multicenter, 22-Week, Double-Blind and 30-Week Open-Label Study to Evaluate the Efficacy and Safety of X0002 Spray in Relief of the Signs and Symptoms of Subjects With Osteoarthritis of the Lumbar Spine

This is a Phase 3, Multicenter, Randomized, 22 Week, Double-Blind, Placebo Controlled and 3-Week, Open-Label Study to Evaluate the Efficacy and Safety of X0002 Spray in relief of the signs and symptoms of Subjects with Osteoarthritis of the Lumbar Spine. To evaluate the efficacy of X0002 spray compared to placebo for the relief of low back pain disability in subjects with osteoarthritis (OA) of the low back.

Read the detailed description

All subjects who provide informed consent will initiate the Screening Period of at least 14 (±3) days for the assessment of eligibility including radiographic evaluation of the lumbar spine. X-ray images must be collected within 4-11 hours after the subject wakes up. Those subjects who meet preliminary eligibility criteria will be treated with placebo in a subject-blind manner for 14(±3) days from Screening Visit to Day 1. Subjects with a placebo response exceeding 25% improvement in the average Numeric Pain Rating Scale (NPRS) score over the previous 7 days will be excluded. Subjects with a Lane grading of 1 or 2 on their neutral lateral lumbar spine film per the central radiologist are eligible to be enrolled. At Baseline (Day 1), eligible subjects will be randomly assigned to 1 of 2 treatment groups in a 1:1 ratio with a 1:1 ratio of active:placebo within each treatment group (i.e., 1 subject to active treatment and 1 subject to placebo), and stratified evenly according to Lane Radiographic Grading Scale summary score (1 or 2) and gender.

Low back pain intensity as assessed by the average of the NPRS scores recorded in the eDiary for the 7 days prior to the visit will be used for the primary efficacy endpoint as well as secondary efficacy endpoints. Efficacy assessments will be conducted at Screening, and at visits at Day 1 (Baseline) Week 2, Week 4, Week 8, Week 12, Week 22, Week 32, Week 42, and Week 52 (EOT). The patient reported outcomes of Oswestry Disability Index (ODI), Subject Global Assessment, modified Brief Pain Inventory (mBPI) Severity score, mBPI Interference Score, Subject's Clinical Global Impression of Improvement (CGI-I), and Short Form 36-item Health Survey (SF-36) will be used for the secondary or exploratory efficacy endpoints.

Safety assessments will be performed at each scheduled visit and will include assessment of AEs, vital signs (blood pressure, pulse rate, respiratory rate, and oral temperature), clinical laboratories, physical examination, skin irritation, and electrocardiograms (ECGs) as indicated in the schedule of events. Phone calls will be made to the subject by a qualified staff member at the site every 2 weeks between scheduled visits where applicable to collect additional information related to AEs.

Being tested
X0002
Keywords
Osteoarthritis, Lumbar Spine, Pain
Medical subject headings
Osteoarthritis, Spine, Back Pain, Osteoarthritis, Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • X0002Drug

    Also called X-0002

    All subjects who provide informed consent will initiate the Screening Period of at least 14 (±3) days for the assessment of eligibility including radiographic evaluation of the lumbar spine. X-ray images must be collected within 4-11 hours after the subject wakes up. Those subjects who meet preliminary eligibility criteria will be treated with placebo in a subject-blind manner for 14(±3) days from Screening Visit to Day 1. Subjects with a placebo response exceeding 25% improvement in the average NPRS score over the previous 7 days will be excluded. Subjects with a Lane grading of 1 or 2 on their neutral lateral lumbar spine film per the central radiologist are eligible to be enrolled. At Day 1, eligible subjects will be randomly assigned to 1 of 2 treatment groups in a 1:1 ratio with a 1:1 ratio of active:placebo within each treatment group, and stratified evenly according to Lane Radiographic Grading Scale summary score (1 or 2) and gender.

Study groups in NCT03110523
Study groupRoleWhat they receive
Group AExperimentalHigh Dose: X0002 or placebo, BID (in the morning and before going to bed), n=376
Receives: Drug: X0002
Group BExperimentalLow Dose: X0002 or placebo, BID (in the morning and before going to bed), n=376
Receives: Drug: X0002

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Average daily Numeric Pain Rating Scale (NPRS) score [0 (no pain) to 10 (worst pain imaginable] for the 7 days prior to Week 12

    Change from Baseline in the average daily NPRS score for the 7 days prior to Week 12

    Measured: Week 12

Secondary outcomes (8)
  1. Average daily Numeric Pain Rating Scale (NPRS) score [0 (no pain) to 10 (worst pain imaginable] for the 7 days prior to Weeks 2, 4, 8, and 22

    Change from Baseline in the average daily NPRS score for the 7 days prior to Weeks 2, 4, 8, and 22

    Measured: Week 2, 4, 8, and 22

  2. Oswestry Disability Index (ODI) score ( 0 is equated with no disability and 100 is the maximum disability possible) at Weeks 2, 4, 8, 12, and 22

    Change from Baseline in the ODI score at Weeks 2, 4, 8, 12, and 22

    Measured: Week 2, 4, 8, 12, and 22

  3. Subject Global Assessment of disease status at Weeks 2, 4, 8, 12, and 22

    To evaluate the effect of X0002 spray for change of Subject Global Assessment of disease status in subjects with OA of the lumbar spine

    Measured: Week 2, 4, 8, 12, and 22

  4. Modified Brief Pain Inventory (mBPI)-Severity score (on a scale ranging from 0 to 10; '0=No pain and 10=Pain as bad as you can imagine) at Weeks 2, 4, 8, 12, and 22

    To evaluate the change from Baseline in the mBPI-Severity score at Weeks 2, 4, 8, 12, and 22

    Measured: Week 2, 4, 8, 12, and 22

  5. Modified Brief Pain Inventory (mBPI)-Interference score (on a scale ranging from 0 to 10 assessing how pain has interfered with certain functions in the previous 24 hours; '0=Does not interfere and 10=Completely interferes) at Weeks 2, 4, 8, 12, and 22

    To evaluate the effect of X0002 spray for change mBPI-Severity score in subjects with OA of the lumbar spine.

    Measured: Week 2, 4, 8, 12, and 22

  6. Subject Clinician's Clinical Global Impression-Improvement (CGI-I) Score (1=very much improved; 2=much improved; 3=minimally improved; 4=no change; 5=minimally worse; 6=much worse; 7=very much worse) at Weeks 2, 4, 8, 12, and 22

    To evaluate the change from the Baseline in the Subject CGI-I at Weeks 2, 4, 8, 12, and 22

    Measured: Week 2, 4, 8, 12, and 22

  7. Average rescue medication (acetaminophen) consumed for low back pain at Weeks 2, 4, 8, 12, and 22.

    To evaluate the change of the average daily dose in mg of rescue medication (acetaminophen) consumed for low back pain at Weeks 2, 4, 8, 12, and 22.(acetaminophen) consumed for low back pain in subjects with OA of the lumbar spine between 2 visits.

    Measured: Week 2, 4, 8, 12, and 22

  8. Mental Component Summary (MCS) score (lower the score is the more disability) at Weeks 2, 4, 8, 12, and 22

    To evaluate the change from Baseline in the SF-36v2 overall score, Physical Component Summary (PCS) score, and Mental Component Summary (MCS) score at Weeks 2, 4, 8, 12, and 22.

    Measured: Week 2, 4, 8, 12, and 22

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted12 Apr 2017
  2. Study start30 Mar 2023 (estimated)
  3. Primary completion30 Jul 2024 (estimated)
  4. Study completion30 Jul 2025 (estimated)

Why it stopped: Strategic business decision

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase 3
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Masking
Quadruple blind
Who is masked
Participant, Care provider, Investigator, Outcomes assessor
Enrolment
0 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT03110523
Sponsor's protocol ID
TF-X0002-32
Status last verified
Jun 2023
First submitted
10 Mar 2017
Last updated
12 Jun 2023
Results posted
No
FDA-regulated drug
Yes
FDA-regulated device
No
Individual data sharing
No

Questions about this trial

What is this clinical trial studying?

A Phase 3 study testing X0002 in people with Osteoarthritis of the Lumbar Spine and Pain, Back, run by Techfields Pharma Co. Ltd.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 14 inclusion and 39 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: withdrawn, as of the sponsor's last update on 12 Jun 2023. Status can change between updates, so confirm with the study contact before making plans.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

What does this phase mean?

Phase 3 studies compare the treatment with the current standard treatment or a placebo in a large group, to confirm how well it works and watch for side effects.

Not every study follows the same path, and some studies (observational studies, device studies) have no phase.

Are results available for this study?

The study was withdrawn before enrolling participants, so there are no results.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Average daily Numeric Pain Rating Scale (NPRS) score [0 (no pain) to 10 (worst pain imaginable] for the 7 days prior to Week 12 (time frame: Week 12). It is what the study was designed to measure, not a finding.

Where can I read the original study information?
Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 12 Jun 2023.

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