Trial Outcomes & Findings for Study on Safety, Tolerability and Prelimenary Efficacy of LNA043 in Patients Undergoing Autologous Chondrocyte Implantation (NCT NCT03334812)

NCT ID: NCT03334812

Last Updated: 2021-10-07

Results Overview

Sodium MRI-based measurements of change from baseline in glycosaminoglycan (GAG) content were assessed from both defective sites and a nearby healthy cartilage region (as a reference tissue). Specifically, the ratio of normalized sodium signal in the surgically created defect (SCD or donor site) to healthy non-weight bearing region (HNWB), i.e. SCD/HNWB and the defect to be treated (DTBT or main lesion) to healthy weight bearing region (HWB), i.e. DTBT/HWB was of major interest

Recruitment status

TERMINATED

Study phase

PHASE2

Target enrollment

14 participants

Primary outcome timeframe

Baseline, Week 4

Results posted on

2021-10-07

Participant Flow

All patients were recruited from 3 clinical sites in Austria.

The original set up of this trial was for 2 cohorts of LNA043 (20 mg and 40 mg). The trial was terminated before any patient in the LNA043 40 mg cohort was randomized

Participant milestones

Participant milestones
Measure
LNA043 20mg
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
Matching placebo to 20mg/3ml, single dose
LNA043 40mg
LNA043 40mg/4ml single dose
Matching Placebo to 40mg
Matching placebo to 40mg/4ml, single dose
Overall Study
STARTED
9
5
0
0
Overall Study
COMPLETED
9
5
0
0
Overall Study
NOT COMPLETED
0
0
0
0

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

Study on Safety, Tolerability and Prelimenary Efficacy of LNA043 in Patients Undergoing Autologous Chondrocyte Implantation

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
LNA043 20mg
n=9 Participants
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
n=5 Participants
Matching placebo to 20mg/3ml, single dose
Total
n=14 Participants
Total of all reporting groups
Age, Continuous
31.0 years
STANDARD_DEVIATION 6.16 • n=99 Participants
39.4 years
STANDARD_DEVIATION 7.40 • n=107 Participants
34.0 years
STANDARD_DEVIATION 7.60 • n=206 Participants
Sex: Female, Male
Female
3 Participants
n=99 Participants
5 Participants
n=107 Participants
8 Participants
n=206 Participants
Sex: Female, Male
Male
6 Participants
n=99 Participants
0 Participants
n=107 Participants
6 Participants
n=206 Participants
Race/Ethnicity, Customized
White
9 Participants
n=99 Participants
5 Participants
n=107 Participants
14 Participants
n=206 Participants

PRIMARY outcome

Timeframe: Baseline, Week 4

Population: Pharmacodynamic analysis set. Subjects with any available PD data, who received any study drug and experienced no protocol deviations with relevant impact on PD data.

Sodium MRI-based measurements of change from baseline in glycosaminoglycan (GAG) content were assessed from both defective sites and a nearby healthy cartilage region (as a reference tissue). Specifically, the ratio of normalized sodium signal in the surgically created defect (SCD or donor site) to healthy non-weight bearing region (HNWB), i.e. SCD/HNWB and the defect to be treated (DTBT or main lesion) to healthy weight bearing region (HWB), i.e. DTBT/HWB was of major interest

Outcome measures

Outcome measures
Measure
LNA043 20mg
n=7 Participants
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
n=2 Participants
Matching placebo to 20mg/3ml, single dose
Change From Baseline in GAG Content
SCD/HNWB
0.24 Ratio
Standard Error 0.06
0.06 Ratio
Standard Error 0.12
Change From Baseline in GAG Content
DTBT/HWB
0.08 Ratio
Standard Error 0.04
0.09 Ratio
Standard Error 0.09

PRIMARY outcome

Timeframe: Week 4

Population: Pharmacodynamic analysis set. Subjects with any available PD data, who received any study drug and experienced no protocol deviations with relevant impact on PD data.

MRI T2 maps were generated and zonal T2 ratios (superficial layer T2 / deep layer T2) were calculated to assess the collagen fiber organization in the surgically created defect (SCD) and defect to be treated (DTBT) cartilage regions.

Outcome measures

Outcome measures
Measure
LNA043 20mg
n=7 Participants
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
n=4 Participants
Matching placebo to 20mg/3ml, single dose
Bi-layer Collagen Organization Based on MRI Measurements
1.01 Ratio
Standard Error 0.07
0.95 Ratio
Standard Error 0.09

SECONDARY outcome

Timeframe: Week 4

Population: Pharmacodynamic analysis set. Subjects with any available PD data, who received any study drug and experienced no protocol deviations with relevant impact on PD data.

Extent of the repair tissue at the donor site before surgery. Each criterion was evaluated based on the visual analog scale and graded from 0 (best) to 100 (worst).

Outcome measures

Outcome measures
Measure
LNA043 20mg
n=8 Participants
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
n=4 Participants
Matching placebo to 20mg/3ml, single dose
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Abnormal Calcification/Ossification
98.75 Unit on a scale
Standard Error 1.05
100.00 Unit on a scale
Standard Error 1.48
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Cell Morphology
61.43 Unit on a scale
Standard Error 14.14
56.67 Unit on a scale
Standard Error 21.60
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Chondrocyte clustering
85.71 Unit on a scale
Standard Error 8.37
85.00 Unit on a scale
Standard Error 12.78
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Inflammation
92.50 Unit on a scale
Standard Error 2.15
98.75 Unit on a scale
Standard Error 3.04
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Matrix Staining
57.14 Unit on a scale
Standard Error 12.17
25.00 Unit on a scale
Standard Error 18.59
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Overall assessment
49.29 Unit on a scale
Standard Error 12.23
55.00 Unit on a scale
Standard Error 18.68
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Tissue Morphology
71.43 Unit on a scale
Standard Error 7.78
65.00 Unit on a scale
Standard Error 11.88
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Vascularisation in repaired tissue
66.25 Unit on a scale
Standard Error 12.88
77.50 Unit on a scale
Standard Error 18.21
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Basal Integration
82.86 Unit on a scale
Standard Error 10.64
90.00 Unit on a scale
Standard Error 16.26
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Formation of a Tidemark
65.71 Unit on a scale
Standard Error 18.15
63.33 Unit on a scale
Standard Error 27.72
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Mid/Deep zone assessment
50.00 Unit on a scale
Standard Error 14.56
56.67 Unit on a scale
Standard Error 22.24
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Subcondral bone abnormalities/marrow fibrosis
73.75 Unit on a scale
Standard Error 13.45
77.50 Unit on a scale
Standard Error 19.01
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Surface Architecture
57.86 Unit on a scale
Standard Error 11.33
80.00 Unit on a scale
Standard Error 17.31
Change From Baseline in International Cartilage Repair Society (ICRS) Scoring
Surface/Superficial assessment
56.43 Unit on a scale
Standard Error 11.42
83.33 Unit on a scale
Standard Error 17.44

SECONDARY outcome

Timeframe: Baseline, Week 4, Week 12 and Week 28

Population: Pharmacodynamic analysis set. Subjects with any available PD data, who received any study drug and experienced no protocol deviations with relevant impact on PD data.

Extent of filling of the donor site over a longer term. Percentage change from baseline in refilling of cartilage defect based on 7T MRI for donor Region.

Outcome measures

Outcome measures
Measure
LNA043 20mg
n=8 Participants
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
n=4 Participants
Matching placebo to 20mg/3ml, single dose
Percentage of Donor Site Refilling Based on MRI Measurements.
Week 12
60.25 Percent
Standard Error 14.55
32.44 Percent
Standard Error 19.09
Percentage of Donor Site Refilling Based on MRI Measurements.
Week 28 (EOS)
86.53 Percent
Standard Error 11.09
62.73 Percent
Standard Error 14.52
Percentage of Donor Site Refilling Based on MRI Measurements.
Week 4
64.38 Percent
Standard Error 7.80
38.15 Percent
Standard Error 11.03

SECONDARY outcome

Timeframe: Baseline, Week 12 and Week 28

Population: Pharmacodynamic analysis set. Subjects with any available PD data, who received any study drug and experienced no protocol deviations with relevant impact on PD data.

Sodium MRI-based measurements of change from baseline in glycosaminoglycan (GAG) content was assessed from both defective sites and a nearby healthy cartilage region (as a reference tissue). Specifically, the ratio of normalized sodium signal in the surgically created defect (SCD or donor site) to healthy non-weight bearing region (HNWB), i.e. SCD/HNWB was of major interest

Outcome measures

Outcome measures
Measure
LNA043 20mg
n=7 Participants
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
n=4 Participants
Matching placebo to 20mg/3ml, single dose
Change From Baseline in GAG Content
SCD/HNWB - Week 12
0.14 Ratio
Standard Error 0.07
0.15 Ratio
Standard Error 0.09
Change From Baseline in GAG Content
SCD/HNWB - Week 28
0.33 Ratio
Standard Error 0.10
0.14 Ratio
Standard Error 0.14

SECONDARY outcome

Timeframe: Week 12 and Week 28

Population: Pharmacodynamic analysis set. Subjects with any available PD data, who received any study drug and experienced no protocol deviations with relevant impact on PD data.

MRI T2 maps were generated and zonal T2 ratios (superficial layer T2 / deep layer T2) were calculated to assess the collagen fiber organization in the SCD cartilage region.

Outcome measures

Outcome measures
Measure
LNA043 20mg
n=6 Participants
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
n=4 Participants
Matching placebo to 20mg/3ml, single dose
Bi-layer Collagen Organization Based on MRI Measurements
Week 12
1.44 Ratio
Standard Error 0.15
1.57 Ratio
Standard Error 0.18
Bi-layer Collagen Organization Based on MRI Measurements
Week 28
1.33 Ratio
Standard Error 0.11
1.45 Ratio
Standard Error 0.14

SECONDARY outcome

Timeframe: 4 weeks

Population: Pharmacokinetic Analysis Set

Local and systemic pharmacokinetics (PK) of LNA043 following a single i.a. administration

Outcome measures

Outcome measures
Measure
LNA043 20mg
n=8 Participants
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
n=5 Participants
Matching placebo to 20mg/3ml, single dose
PK Profile of LNA043 and of AngPTL3 in Serum Cmax
LNA043
57.4 ng/mL
Standard Deviation 22.1
PK Profile of LNA043 and of AngPTL3 in Serum Cmax
AngPTL3
22.9 ng/mL
Standard Deviation 9.03
26.6 ng/mL
Standard Deviation 7.62

SECONDARY outcome

Timeframe: 4 weeks

Population: Pharmacokinetic Analysis Set

Local and systemic pharmacokinetics (PK) of LNA043 following a single i.a. administration

Outcome measures

Outcome measures
Measure
LNA043 20mg
n=8 Participants
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
n=5 Participants
Matching placebo to 20mg/3ml, single dose
PK Profile of LNA043 and of AngPTL3 in Serum AUC
LNA043
821 hr*ng/mL
Standard Deviation 349
PK Profile of LNA043 and of AngPTL3 in Serum AUC
AngPTL3
3130 hr*ng/mL
Standard Deviation 1440
3030 hr*ng/mL
Standard Deviation 1060

SECONDARY outcome

Timeframe: Baseline, Week 1, Week 4, Week 12 and Week 28

Population: Safety Analysis Set

Potential immunogenicity of LNA043

Outcome measures

Outcome measures
Measure
LNA043 20mg
n=9 Participants
LNA043 20mg/3ml single dose
Matching Placebo to 20mg
n=5 Participants
Matching placebo to 20mg/3ml, single dose
Number of Participants With Anti-LNA043 Antibodies in Serum
Day 8: anti-LNA043 antibodies present · NO
9 Participants
5 Participants
Number of Participants With Anti-LNA043 Antibodies in Serum
Day 29: anti-LNA043 antibodies present · YES
0 Participants
0 Participants
Number of Participants With Anti-LNA043 Antibodies in Serum
Day 1: anti-LNA043 antibodies present · YES
0 Participants
0 Participants
Number of Participants With Anti-LNA043 Antibodies in Serum
Day 1: anti-LNA043 antibodies present · NO
9 Participants
5 Participants
Number of Participants With Anti-LNA043 Antibodies in Serum
Day 8: anti-LNA043 antibodies present · YES
0 Participants
0 Participants
Number of Participants With Anti-LNA043 Antibodies in Serum
Day 29: anti-LNA043 antibodies present · NO
9 Participants
5 Participants
Number of Participants With Anti-LNA043 Antibodies in Serum
Day 85: anti-LNA043 antibodies present · YES
0 Participants
0 Participants
Number of Participants With Anti-LNA043 Antibodies in Serum
Day 85: anti-LNA043 antibodies present · NO
9 Participants
5 Participants
Number of Participants With Anti-LNA043 Antibodies in Serum
Day 197: anti-LNA043 antibodies present · YES
0 Participants
0 Participants
Number of Participants With Anti-LNA043 Antibodies in Serum
Day 197: anti-LNA043 antibodies present · NO
9 Participants
5 Participants

Adverse Events

LNA043 20mg

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Placebo

Serious events: 0 serious events
Other events: 4 other events
Deaths: 0 deaths

Serious adverse events

Adverse event data not reported

Other adverse events

Other adverse events
Measure
LNA043 20mg
n=9 participants at risk
LNA043 20mg
Placebo
n=5 participants at risk
Placebo
Ear and labyrinth disorders
Vertigo
11.1%
1/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
0.00%
0/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
Endocrine disorders
Thyroid mass
0.00%
0/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
20.0%
1/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
Gastrointestinal disorders
Nausea
0.00%
0/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
40.0%
2/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
General disorders
Influenza like illness
11.1%
1/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
0.00%
0/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
Infections and infestations
Nasopharyngitis
0.00%
0/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
20.0%
1/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
Infections and infestations
Urinary tract infection
0.00%
0/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
20.0%
1/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
Injury, poisoning and procedural complications
Contusion
11.1%
1/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
0.00%
0/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
Injury, poisoning and procedural complications
Fall
11.1%
1/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
0.00%
0/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
Injury, poisoning and procedural complications
Traumatic haematoma
11.1%
1/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
0.00%
0/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
Musculoskeletal and connective tissue disorders
Arthralgia
11.1%
1/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
0.00%
0/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
Musculoskeletal and connective tissue disorders
Joint range of motion decreased
0.00%
0/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
20.0%
1/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
Nervous system disorders
Headache
22.2%
2/9 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment
0.00%
0/5 • Adverse events were collected from the dose of study treatment until up to 28 weeks post treatment

Additional Information

Study Director

Novartis Pharmaceuticals

Phone: 862-778-8300

Results disclosure agreements

  • Principal investigator is a sponsor employee The terms and conditions of Novartis' agreements with its investigators may vary. However, Novartis does not prohibit any investigator from publishing. Any publications from a single-site are postponed until the publication of the pooled data (ie, data from all sites) in the clinical trial.
  • Publication restrictions are in place

Restriction type: OTHER