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Osteoarthritis of KneePhase 1/2NCT06989645

A Phase 1/2a Study to Evaluate Single Intraarticular Injections of 3 Dose Levels of SYN321 and Placebo in Patients With Symptomatic Knee Osteoarthritis

A Phase 1/2 study testing SYN321 in people with Osteoarthritis of Knee, run by Synartro AB at 1 site in Sweden.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This is a, phase 1/2a trial, to assess the safety, tolerability, systemic exposure as well as preliminary efficacy following a single intra-articular injection of 3 dose levels of SYN321 in patients with symptomatic knee osteoarthritis (KOA). Read more about this study

Who is it for?
Ages 40 to 79 years
Conditions the study is for
Osteoarthritis of Knee
What is being tested?
SYN321
Could I receive a placebo?
Yes, some participants may receive a placebo
How many people
35 participants
Where
1 siteSweden
Study dates
19 Aug 2025to 2 Mar 2026
Phase
Phase 1/2
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 40 to 79 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • Willing and able to give electronically informed consent for participation in the trial and willing and able to participate in all procedures and follow-up evaluations necessary to complete the trial.
  • Male or female patient clinically diagnosed with KOA, no later than 3 months prior to Visit 1. The KOA diagnosis should be confirmed in the patient's medical record.
  • Dominant pain in one knee due to KOA with weight bearing pain between 4 and 8 inclusive on the NRS scale (0-10) at the time of inclusion (checked at screening [Visit 1] and confirmed at Visit 2, pain during the last 7 days).
  • Age 40 to 79 years, inclusive at the time of Visit 1.
  • Body mass index (BMI) ≥ 18.5 and < 35.0 kg/m2.
  • Patients without abnormal clinically significant medical history, physical findings, vital signs, hypotension, cardiovascular disease, ECG, and laboratory values at the time of the screening visit, as judged by the Investigator. (Discussion is encouraged between the Investigator and the Medical Monitor regarding the clinical relevance of any abnormal laboratory value during the pre-dose period.)
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  • Patient is willing to discontinue all pain medication (COX-2 inhibitors, NSAIDs, and opioid analgesics) at least 10 days before trial drug administration (prior to Day 1) and for the trial duration. Paracetamol will be allowed as rescue medication up to max 4000 mg/day (except for 24 hours prior to visit to the trial site).
  • Patient agrees not to take additional knee symptom-modifying drugs (e.g., glucosamine, collagen, HA) at least 10 days before trial drug administration (prior to Day 1) and for the trial duration.
  • WOCBP must practice abstinence heterosexual intercourse (only allowed when this is the preferred and usual lifestyle of the patient) or agree to use a highly effective method of contraception with a failure rate of < 1 % to prevent pregnancy from that least 2 weeks prior to the administration of IMP to 4 weeks after the last administration of IMP. In addition, any male partner of a female patient must, unless he has undergone vasectomy, agree to use a condom from the first administration of IMP until 4 weeks after the last administration of IMP.
  • The following are considered highly effective methods of contraception:
  • combined (estrogen and progestogen containing) hormonal contraception associated with inhibition of ovulation (oral, intravaginal, transdermal),
  • progestogen-only hormonal contraception associated with inhibition of ovulation (oral, injectable, implantable),
  • intrauterine device [IUD]or intrauterine hormone-releasing system [IUS]). WOCBP must refrain from donating eggs from the first IMP administration until 3 months after the last IMP administration.
  • Women of non-childbearing potential are pre-menopausal females who have undergone any of the following surgical procedures; hysterectomy, bilateral salpingectomy, or bilateral oophorectomy, or who are post-menopausal defined as 12 months of amenorrhea (in questionable cases a blood sample with detection of follicle stimulating hormone [FSH] >25 IU/L is confirmatory).
  • Male patients must be willing to use condom or be vasectomized or practice sexual abstinence from heterosexual intercourse (only allowed when this is the preferred and usual lifestyle of the patient) to prevent pregnancy and drug exposure of a partner and refrain from donating sperm from the first administration of IMP until 3 months after the last administration of IMP. Any female partner of a non-vasectomized male patient who is of childbearing potential must use contraceptive methods with a failure rate of < 1% to prevent pregnancy (see above) from at least 2 weeks prior to the first administration of IMP to 4 weeks after the last administration of IMP.
  • Patients without contraindications for treatment with diclofenac.

Who cannot join

  • History of any clinically significant disease or disorder which, in the opinion of the Investigator, may either put the patient at risk because of participation in the trial, or influence the results or the patient's ability to participate in the trial.
  • Previous IA fracture of the knee.
  • Patient has rheumatoid arthritis, psoriatic arthritis, or has been diagnosed with any other disorders that is the primary source of their knee pain, including but not limited to: osteonecrosis, radiculopathy, bursitis, tendinitis, tumor, cancer.
  • IA injections of steroids or HA or other invasive procedure (e.g., arthroscopy, arthrography, surgery) in the knee within 3 months prior to screening.
  • Conditions or medications that could confound the assessment of pain, as judged by the Investigator.
  • Conditions that could be adversely affected by an IA injection (e.g., eczema, skin infection, high bleeding risk etc.), as judged by the Investigator.
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  • Any clinically significant illness (except KOA), medical/surgical procedure, or trauma within 4 weeks of the administration of IMP.
  • Malignancy within the past 5 years, with the exception of in situ removal of basal cell carcinoma.
  • Any planned major surgery within the duration of the trial.
  • Patients who are pregnant, currently breastfeeding, or intend to become pregnant during the course of the trial.
  • Any positive result on screening for serum hepatitis B surface antigen, hepatitis C antibodies and/or human immunodeficiency virus (HIV).
  • After 10 minutes supine rest at the time of screening, any vital signs outside the following ranges:
  • Systolic blood pressure (BP): <90 or >160 mmHg, or
  • Diastolic blood pressure <50 or >95 mmHg, or
  • Pulse <40 or >90 bpm
  • Prolonged QTcF (> 450 ms), cardiac arrhythmias or any clinically significant abnormalities in the resting ECG at the time of screening, as judged by the Investigator.
  • History of severe allergy/hypersensitivity or ongoing allergy/hypersensitivity, as judged by the Investigator, or history of hypersensitivity to drugs with a similar chemical structure or class to SYN321, including disinfectants and adhesives or hypersensitivity to acetylsalicylic acid.
  • History of asthma, angioedema, urticaria or acute rhinitis induced by NSAID, including acetylsalicylic acid.
  • Regular use of any prescribed or non-prescribed medications, including but not limited to antacids, analgesics, herbal remedies, vitamins and minerals, within 10 days prior to the first administration of IMP, as well as nasal decongestants without cortisone, antihistamine, or anticholinergics for a maximum of 10 days, at the discretion of the Investigator.
  • Patient has taken pain medication or has received pain medicine other than paracetamol for conditions unrelated to KOA of the index knee within 10 days prior to the injection.
  • Planned treatment or treatment with another investigational drug within 3 months prior to Day 1. Patients consented and screened but not dosed in previous phase 1 studies will not be excluded.
  • Current smokers or users of nicotine products. Irregular use of nicotine (e.g., smoking, snuffing, chewing tobacco) less than 3 times/week before the screening visit will be allowed.
  • Positive screen for drugs of abuse or alcohol at screening. Positive results that are expected given the patient's medical history and prescribed medications can be disregarded as judged by the Investigator.
  • History of or current alcohol abuse or excessive intake of alcohol, as judged by the Investigator.
  • History of or current drug abuse, as judged by the Investigator.
  • History of or current use of anabolic steroids, as judged by the Investigator.
  • Plasma donation within 1 month of screening or blood donation (or corresponding blood loss) during the last 3 months prior to screening.
  • The Investigator considers the patient unlikely to comply with trial procedures, restrictions, and requirements.

Trial locations and contacts

1 site in 1 country.

Sweden1 site
  • Cinical Trial Consultants AB

    Uppsala

Other trials in Sweden

About this study

Official title: A Prospective, Double-blinded, Randomized, Placebo-controlled Phase 1/2a Study to Assess Safety, Tolerability, Systemic Exposure, and Preliminary Efficacy of Single Intraarticular Injections of 3 Dose Levels of SYN321 and Placebo in Patients With Symptomatic Knee Osteoarthritis

This is a, phase 1/2a trial, to assess the safety, tolerability, systemic exposure as well as preliminary efficacy following a single intra-articular injection of 3 dose levels of SYN321 in patients with symptomatic knee osteoarthritis (KOA).

Read the detailed description

Participants will receive a single intra-articular injection of SYN321 or placebo. 4 sequential cohorts are planned. The fourth cohort will repeat one of the previously 3 administered dose levels. The first 2 participants in each cohort will be dosed in a sentinel fashion. The participants will be followed for 56 days.

Being tested
SYN321, Placebo
Keywords
knee osteoarthritis
Medical subject headings
Osteoarthritis, Knee

What participants receive

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

  • SYN321Drug

    Intra-articular

  • PlaceboDrug

    Also called NaCl 9 mg/mL

    Intra-articular

Study groups in NCT06989645
Study groupRoleWhat they receive
SYN321, dose level 1Active comparatorCohort 1: 6 participants recieves SYN321.
Receives: Drug: SYN321
SYN321, dose level 2Active comparatorCohort 2: 6 participants recieves SYN321.
Receives: Drug: SYN321
SYN321, dose level 3Active comparatorCohort 3: 6 participants recieves SYN321.
Receives: Drug: SYN321
SYN321, dose level 1,2 or 3Active comparatorCohort 4: 6 participants recieves SYN321.
Receives: Drug: SYN321
PlaceboPlacebo comparatorPlacebo: 2 participants each from cohort 1, 2 and 3, and 6 participants from cohort 4 receive placebo.
Receives: Drug: Placebo

What is being measured

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

  1. Incidence and intensity of adverse events

    Frequency, intensity and seriousness of adverse events (AEs) will be assesed. The intensity grades is defined as mild, moderate or severe. AEs will be assessed as not related, possibly or probably related to SYN321

    Measured: From IMP injection (day 1) until end of trial visit (day 56)

  2. Clinically significant changes in ECG

    Single 12-lead ECGs will be recorded in supine position after 10 minutes of rest using an ECG machine. The resting heart rate and PQ/PR, QRS, QT and QTcF intervals will be recorded. Any values outside of normal ranges will be judged as clinically significant or not clinically significant by the Investigator. Abnormal post-IMP administration findings assessed by the Investigator as clinically significant will be reported as Adverse Events.

    Measured: From screening until end of trial visit (day 56)

  3. Clinically significant changes in blood pressure

    Systolic and diastolic blood pressure and pulse will be measured in supine positionafter 10 minutes of rest. Any vital signs outside of normal ranges will be judged as clinically significant or not clinically significant by the Investigator. Abnormal post-IMP administration findings assessed by the Investigator as clinically significant will be reported as Adverse Events.

    Measured: From screening until end of trial visit (day 56)

  4. Clinically significant changes in heart rate

    Heart rate will be measured in supine position after 10 minutes of rest. Any vital signs outside of normal ranges will be judged as clinically significant or not clinically significant by the Investigator. Abnormal post-IMP administration findings assessed by the Investigator as clinically significant will be reported as Adverse Events.

    Measured: From screening until end of trial visit (day 56)

  5. Clinically significant changes in body temperature

    Body temperature will be measured in supine position after 10 minutes of rest. Any vital signs outside of normal ranges will be judged as clinically significant or not clinically significant by the Investigator. Abnormal post-IMP administration findings assessed by the Investigator as clinically significant will be reported as Adverse Events.

    Measured: From screening until end of trial visit (day 56)

  6. Clinically significant changes in Clinical Laboratory Profile

    Safety laboratory data, Clinical chemistry, haematology, and coagulation, will be measured. Any values outside of normal ranges will be judged as clinically significant or not clinically significant by the Investigator. Abnormal post-IMP administration findings assessed by the Investigator as clinically significant will be reported as Adverse Events.

    Measured: From screening until end of trial visit (day 56)

  7. Clinically significant changes in urine analysis

    Urine analysis will be performed. Any values outside of normal ranges will be judged as clinically significant or not clinically significant by the Investigator. Abnormal post-IMP administration findings assessed by the Investigator as clinically significant will be reported as Adverse Events.

    Measured: From screening until end of trial visit (day 56)

  8. Clinically significant changes in Physical Examination

    Assessment of different organ systems. Any abnormalities will be specified and documented as clinically significant or not clinically significant. Abnormal post-IMP administration findings assessed by the Investigator as clinically significant will be reported as AEs

    Measured: From screening until end of trial visit (day 56)

  9. Clinically significant changes of local tolerability reactions

    The infusion site area will be visually inspected at baseline and follow up-visits after the IMP injection. The assessment will include the Investigator's evaluation of swelling, Redness and warmth. Abnormal post-IMP administration findings assessed by the Investigator as clinically significant will be reported as AEs.

    Measured: From screening until end of trial visit (day 56)

Secondary outcomes (10)
  1. Pharmacokinetic (PK) parameter in plasma - Cmax

    Venous samples for the determination of plasma concentrations (Cmax) of diclofenac and diclofenac lactam (break down products from SYN321) will be collected.

    Measured: From IMP injection (day 1) until end of trial visit (day 56)

  2. Pharmacokinetic (PK) parameter in plasma - Cmax

    Venous samples for the determination of plasma concentrations (Cmax) of linker and linker associated metabolites (break down products from SYN321) will be collected.

    Measured: From IMP injection (day 1) until end of trial visit (day 56)

  3. Pharmacokinetic (PK) parameter in urine - Cmax

    Urine samples for the determination of plasma concentrations (Cmax) of diclofenac and diclofenac lactam (break down products from SYN321) will be collected.

    Measured: From IMP injection (day 1) until end of trial visit (day 56)

  4. Pharmacokinetic (PK) parameter in urine - Cmax

    Urine samples for the determination of plasma concentrations (Cmax) of linker and linker associated metabolites (break down products from SYN321) will be collected.

    Measured: From IMP injection (day 1) until end of trial visit (day 56)

  5. Pharmacokinetic (PK) parameter in plasma - AUC

    Venous samples for the determination of plasma concentrations (AUC) of diclofenac and diclofenac lactam (break down products from SYN321) will be collected.

    Measured: From IMP injection (day 1) until end of trial visit (day 56)

  6. Pharmacokinetic (PK) parameter in plasma - AUC

    Venous samples for the determination of plasma concentrations (AUC) of linker and linker associated metabolites (break down products from SYN321) will be collected.

    Measured: From IMP injection (day 1) until end of trial visit (day 56)

  7. Pharacokinetic (PK) parameter in urine - AUC

    Urine samples for the determination of plasma concentrations (AUC) of diclofenac and diclofenac lactam (break down products from SYN321) will be collected.

    Measured: From IMP injection (day 1) until end of trial visit (day 56)

  8. Self-registered pain in knee

    Self-registered pain using the NRS (0-10). Score 0 indicates 'no pain' and 10 indicates 'pain as bad as you can imagine'.

    Measured: From screening until end of trial visit (day 56)

  9. Self-registered function

    Self-registered function using KOOS (Knee Injury and Osteoarthritis Outcome Score). Change from baseline in average sum of KOOS scores, KOOS subscale scores. The patients will assign scores (0-4, where 0 corresponds to "none" and 4 corresponds to "extreme").

    Measured: From IMP injection until end of trial visit (day 56)

  10. Self-registered quality of life

    Self-registered function using KOOS (Knee Injury and Osteoarthritis Outcome Score). Change from baseline in average sum of KOOS scores, KOOS subscale scores. The patients will assign scores (0-4, where 0 corresponds to "none" and 4 corresponds to "extreme").

    Measured: From IMP injection until end of trial visit (day 56)

Timeline

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

  1. First posted25 May 2025
  2. Study start19 Aug 2025
  3. Primary completion2 Feb 2026
  4. Study completion2 Mar 2026

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 1/2
Primary purpose
Basic science
Allocation
Randomised
Intervention model
Sequential
Masking
Double blind
Who is masked
Participant, Investigator
Enrolment
35 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT06989645
Sponsor's protocol ID
SYN321-01
Other IDs
2024-517920-21-00
Status last verified
Mar 2026
First submitted
16 May 2025
Last updated
6 Mar 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Undecided

Questions about this trial

What is this clinical trial studying?

A Phase 1/2 study testing SYN321 in people with Osteoarthritis of Knee, run by Synartro AB at 1 site in Sweden.

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 16 inclusion and 28 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: finished, as of the sponsor's last update on 6 Mar 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in Sweden. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

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

What does this combined phase mean?

Phase 1 studies test a treatment in a small group of people for the first time or in a new way, mainly to check safety and find the right dose.

Phase 2 studies give the treatment to a larger group to see whether it has the intended effect and to keep checking safety.

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 is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

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?

Incidence and intensity of adverse events (time frame: From IMP injection (day 1) until end of trial visit (day 56)). The study lists 9 primary outcomes in all. 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 6 Mar 2026.

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