Trial Outcomes & Findings for Study to Evaluate the Efficacy and Safety of EP-104IAR in Patients With Osteoarthritis of the Knee (NCT NCT04120402)

NCT ID: NCT04120402

Last Updated: 2024-06-25

Results Overview

Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (scores scaled 0-10, with 10 being the worst). Least squares mean from a mixed model for repeated measures (MMRM) for change from baseline with fixed effects for site, treatment, week, treatment-by-week interaction; random effect for subject; and covariate baseline WOMAC pain score.

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

318 participants

Primary outcome timeframe

12 weeks

Results posted on

2024-06-25

Participant Flow

Participant milestones

Participant milestones
Measure
EP-104IAR 25 mg
A single use intra-articular injection containing 25 mg of EP-104IAR EP-104IAR 25 mg: Single 5 mL intra-articular injection
Placebo (Vehicle)
A single use intra-articular injection containing no active ingredients Vehicle: Single 5 mL intra-articular injection
Overall Study
STARTED
163
155
Overall Study
COMPLETED
156
148
Overall Study
NOT COMPLETED
7
7

Reasons for withdrawal

Withdrawal data not reported

Baseline Characteristics

The analysis population is the intent to treat population of 318 patients in total. Out of the 318 patients 163 patients were in the EP-104IAR 25mg arm and 155 patients were in the Placebo (Vehicle) arm.

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
EP-104IAR 25 mg
n=163 Participants
A single use intra-articular injection containing 25 mg of EP-104IAR EP-104IAR 25 mg: Single 5 mL intra-articular injection
Placebo (Vehicle)
n=155 Participants
A single use intra-articular injection containing no active ingredients Vehicle: Single 5 mL intra-articular injection
Total
n=318 Participants
Total of all reporting groups
Age, Categorical
<=18 years
0 Participants
n=99 Participants • The analysis population is the intent to treat population of 318 patients in total. Out of the 318 patients 163 patients were in the EP-104IAR 25mg arm and 155 patients were in the Placebo (Vehicle) arm.
0 Participants
n=107 Participants • The analysis population is the intent to treat population of 318 patients in total. Out of the 318 patients 163 patients were in the EP-104IAR 25mg arm and 155 patients were in the Placebo (Vehicle) arm.
0 Participants
n=206 Participants • The analysis population is the intent to treat population of 318 patients in total. Out of the 318 patients 163 patients were in the EP-104IAR 25mg arm and 155 patients were in the Placebo (Vehicle) arm.
Age, Categorical
Between 18 and 65 years
91 Participants
n=99 Participants • The analysis population is the intent to treat population of 318 patients in total. Out of the 318 patients 163 patients were in the EP-104IAR 25mg arm and 155 patients were in the Placebo (Vehicle) arm.
89 Participants
n=107 Participants • The analysis population is the intent to treat population of 318 patients in total. Out of the 318 patients 163 patients were in the EP-104IAR 25mg arm and 155 patients were in the Placebo (Vehicle) arm.
180 Participants
n=206 Participants • The analysis population is the intent to treat population of 318 patients in total. Out of the 318 patients 163 patients were in the EP-104IAR 25mg arm and 155 patients were in the Placebo (Vehicle) arm.
Age, Categorical
>=65 years
72 Participants
n=99 Participants • The analysis population is the intent to treat population of 318 patients in total. Out of the 318 patients 163 patients were in the EP-104IAR 25mg arm and 155 patients were in the Placebo (Vehicle) arm.
66 Participants
n=107 Participants • The analysis population is the intent to treat population of 318 patients in total. Out of the 318 patients 163 patients were in the EP-104IAR 25mg arm and 155 patients were in the Placebo (Vehicle) arm.
138 Participants
n=206 Participants • The analysis population is the intent to treat population of 318 patients in total. Out of the 318 patients 163 patients were in the EP-104IAR 25mg arm and 155 patients were in the Placebo (Vehicle) arm.
Age, Continuous
64.0 years
STANDARD_DEVIATION 9.31 • n=99 Participants
63.2 years
STANDARD_DEVIATION 9.37 • n=107 Participants
63.6 years
STANDARD_DEVIATION 9.33 • n=206 Participants
Sex: Female, Male
Female
94 Participants
n=99 Participants
89 Participants
n=107 Participants
183 Participants
n=206 Participants
Sex: Female, Male
Male
69 Participants
n=99 Participants
66 Participants
n=107 Participants
135 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Hispanic or Latino
1 Participants
n=99 Participants
2 Participants
n=107 Participants
3 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Not Hispanic or Latino
161 Participants
n=99 Participants
152 Participants
n=107 Participants
313 Participants
n=206 Participants
Ethnicity (NIH/OMB)
Unknown or Not Reported
1 Participants
n=99 Participants
1 Participants
n=107 Participants
2 Participants
n=206 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
Asian
0 Participants
n=99 Participants
1 Participants
n=107 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Black or African American
1 Participants
n=99 Participants
0 Participants
n=107 Participants
1 Participants
n=206 Participants
Race (NIH/OMB)
White
162 Participants
n=99 Participants
153 Participants
n=107 Participants
315 Participants
n=206 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Race (NIH/OMB)
Unknown or Not Reported
0 Participants
n=99 Participants
0 Participants
n=107 Participants
0 Participants
n=206 Participants
Region of Enrollment
Czechia
40 participants
n=99 Participants
35 participants
n=107 Participants
75 participants
n=206 Participants
Region of Enrollment
Denmark
85 participants
n=99 Participants
84 participants
n=107 Participants
169 participants
n=206 Participants
Region of Enrollment
Poland
38 participants
n=99 Participants
36 participants
n=107 Participants
74 participants
n=206 Participants

PRIMARY outcome

Timeframe: 12 weeks

Population: The intention-to-treat (ITT) population consists of all subjects who were both randomized to and received treatment. Analysis was conducted allocating subjects to the treatment to which they were randomized, irrespective of what was actually received.

Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (scores scaled 0-10, with 10 being the worst). Least squares mean from a mixed model for repeated measures (MMRM) for change from baseline with fixed effects for site, treatment, week, treatment-by-week interaction; random effect for subject; and covariate baseline WOMAC pain score.

Outcome measures

Outcome measures
Measure
EP-104IAR 25 mg
n=163 Participants
A single use intra-articular injection containing 25 mg of EP-104IAR EP-104IAR 25 mg: Single 5 mL intra-articular injection
Placebo (Vehicle)
n=155 Participants
A single use intra-articular injection containing no active ingredients Vehicle: Single 5 mL intra-articular injection
Difference in Change From Baseline Between EP-104IAR and Vehicle in WOMAC Pain Subscale
-2.89 score on a scale
Standard Error 0.166
-2.23 score on a scale
Standard Error 0.171

SECONDARY outcome

Timeframe: 12 weeks

Population: The intention-to-treat (ITT) population consists of all subjects who were both randomized to and received treatment. Analysis was conducted allocating subjects to the treatment to which they were randomized, irrespective of what was actually received.

Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) function subscale (scores scaled 0-10, with 10 being the worst). Function subscale includes questions related to the physical functioning of osteoarthritis e.g. stair use, standing, walking etc. From a mixed model for repeated measures (MMRM) for change from baseline with fixed effects for site, treatment, week, treatment-by-week interaction; random effect for subject; and covariate baseline WOMAC function score.

Outcome measures

Outcome measures
Measure
EP-104IAR 25 mg
n=163 Participants
A single use intra-articular injection containing 25 mg of EP-104IAR EP-104IAR 25 mg: Single 5 mL intra-articular injection
Placebo (Vehicle)
n=155 Participants
A single use intra-articular injection containing no active ingredients Vehicle: Single 5 mL intra-articular injection
Difference in Change From Baseline Between EP-104IAR and Vehicle in WOMAC Function Subscale
-2.59 score on a scale
Standard Error 0.161
-2.04 score on a scale
Standard Error 0.166

SECONDARY outcome

Timeframe: 12 weeks

Population: The intention-to-treat (ITT) population consists of all subjects who were both randomized to and received treatment. Analysis was conducted allocating subjects to the treatment to which they were randomized, irrespective of what was actually received.

Area under the curve in change from baseline Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (scores scaled 0-10, with 10 being the worst) from Week 0 to Week 12 was calculated on a per-individual basis using the linear trapezoidal rule. AUC was normalized to account for subjects whose actual days and nominal days at Week 12 differed. Treatments were compared using an ANCOVA model containing site; individual baseline WOMAC Pain; and treatment group as covariates.

Outcome measures

Outcome measures
Measure
EP-104IAR 25 mg
n=163 Participants
A single use intra-articular injection containing 25 mg of EP-104IAR EP-104IAR 25 mg: Single 5 mL intra-articular injection
Placebo (Vehicle)
n=155 Participants
A single use intra-articular injection containing no active ingredients Vehicle: Single 5 mL intra-articular injection
Difference Between EP-104IAR and Vehicle in the Area Under the Curve (AUC) of WOMAC Pain Subscale
-235.67 score on a scale multiplied by days
Standard Error 11.769
-166.78 score on a scale multiplied by days
Standard Error 12.169

SECONDARY outcome

Timeframe: 24 weeks

Population: The intention-to-treat (ITT) population consists of all subjects who were both randomized to and received treatment. Analysis was conducted allocating subjects to the treatment to which they were randomized, irrespective of what was actually received.

Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain subscale (scores scaled 0-10, with 10 being the worst). Least squares mean from a mixed model for repeated measures (MMRM) for change from baseline with fixed effects for site, treatment, week, treatment-by-week interaction; random effect for subject; and covariate baseline WOMAC pain score.

Outcome measures

Outcome measures
Measure
EP-104IAR 25 mg
n=163 Participants
A single use intra-articular injection containing 25 mg of EP-104IAR EP-104IAR 25 mg: Single 5 mL intra-articular injection
Placebo (Vehicle)
n=155 Participants
A single use intra-articular injection containing no active ingredients Vehicle: Single 5 mL intra-articular injection
Difference in Change From Baseline Between EP-104IAR and Vehicle in WOMAC Pain Subscale
-2.26 score on a scale
Standard Error 0.171
-2.11 score on a scale
Standard Error 0.175

SECONDARY outcome

Timeframe: 12 weeks

Population: The intention-to-treat (ITT) population consists of all subjects who were both randomized to and received treatment. Analysis was conducted allocating subjects to the treatment to which they were randomized, irrespective of what was actually received.

Outcome Measures in Rheumatology-Osteoarthritis Research Society International (OMERACT-OARSI) strict responders are defined as at least 50% improvement (decrease from baseline) in Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain or function subscales (scores scaled 0-10, with 10 being the worst) and an absolute change of at least 2 in the respective score. Patients who discontinued prior to Week 12 were considered non-responders.

Outcome measures

Outcome measures
Measure
EP-104IAR 25 mg
n=163 Participants
A single use intra-articular injection containing 25 mg of EP-104IAR EP-104IAR 25 mg: Single 5 mL intra-articular injection
Placebo (Vehicle)
n=155 Participants
A single use intra-articular injection containing no active ingredients Vehicle: Single 5 mL intra-articular injection
Difference Between EP-104IAR and Vehicle in OMERACT-OARSI Strict Responders
87 Participants
61 Participants

Adverse Events

EP-104IAR 25 mg

Serious events: 4 serious events
Other events: 76 other events
Deaths: 0 deaths

Placebo (Vehicle)

Serious events: 1 serious events
Other events: 68 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
EP-104IAR 25 mg
n=163 participants at risk
A single use intra-articular injection containing 25 mg of EP-104IAR EP-104IAR 25 mg: Single 5 mL intra-articular injection
Placebo (Vehicle)
n=155 participants at risk
A single use intra-articular injection containing no active ingredients Vehicle: Single 5 mL intra-articular injection
Nervous system disorders
Cerebrovascular accident
0.61%
1/163 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
0.00%
0/155 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
Injury, poisoning and procedural complications
Accidental overdose
0.61%
1/163 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
0.00%
0/155 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
Nervous system disorders
Loss of consciousness
0.61%
1/163 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
0.00%
0/155 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
Ear and labyrinth disorders
Acute vestibular syndrome
0.61%
1/163 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
0.00%
0/155 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
Neoplasms benign, malignant and unspecified (incl cysts and polyps)
Prostate cancer
0.00%
0/163 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
0.65%
1/155 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.

Other adverse events

Other adverse events
Measure
EP-104IAR 25 mg
n=163 participants at risk
A single use intra-articular injection containing 25 mg of EP-104IAR EP-104IAR 25 mg: Single 5 mL intra-articular injection
Placebo (Vehicle)
n=155 participants at risk
A single use intra-articular injection containing no active ingredients Vehicle: Single 5 mL intra-articular injection
Infections and infestations
Nasopharyngitis
8.6%
14/163 • Number of events 16 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
7.7%
12/155 • Number of events 15 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
Infections and infestations
COVID-19
8.6%
14/163 • Number of events 14 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
9.0%
14/155 • Number of events 14 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
Infections and infestations
Influenza
3.7%
6/163 • Number of events 6 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
5.8%
9/155 • Number of events 9 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
Musculoskeletal and connective tissue disorders
Arthralgia
23.3%
38/163 • Number of events 38 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
14.8%
23/155 • Number of events 26 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
General disorders
Influenza like illness
2.5%
4/163 • Number of events 5 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.
6.5%
10/155 • Number of events 10 • Treatment-emergent adverse events (TEAEs) were summarized and analyzed for safety evaluations i.e, events which occurred from the time of the EP-104IAR or vehicle injection procedure until the Week 24/End-of-Study/Early Exit Visit.

Additional Information

Chief Scientific Officer

Eupraxia Pharmaceuticals Ltd.

Phone: 250-590-3968

Results disclosure agreements

  • Principal investigator is a sponsor employee Investigators may not present or publish partial or complete study results individually without the Sponsor's agreement. Any manuscript or abstract proposed by the Investigators must be reviewed and approved in writing by the Sponsor before submission for publication. Names of all Investigators participating in the study will be included in the publication.
  • Publication restrictions are in place

Restriction type: OTHER