Overview

This trial is active, not recruiting.

Conditions large articular cartilage lesions of the femoral, condyle, trochlea, tibia or retropatellar
Treatment co.don chondrosphere®
Phase phase 2
Sponsor co.don AG
Start date October 2010
End date September 2013
Trial size 75 participants
Trial identifier NCT01225575, 2009-016816-20, cod 16HS14

Summary

This is a prospective, randomised, open label, multicentre Phase II clinical trial to investigate the efficacy and safety of the treatment of large defects with 3 different doses of the autologous chondrocyte transplantation product co.don chondrosphere® (ACT3D-CS) in subjects with cartilage defects of the knee.

After screening visit patients were booked for arthroscopy and had their cells harvesting from healthy cartilage. After the arthroscopy the patients were randomised in one of the three dose-groups. The cells are cultivated for 8-10 weeks in vitro to develope 3-dimensional spheroids, that are transplanted in an open knee procedure (treatment surgery)into the defect. Patients of all dose groups subsequently followed the same rehabilitation program and had post-surgery visits. The 12-month-visit is defined as final assessment. Then patients have follow-up assessments up to 60 months.

United States No locations recruiting
Other Countries No locations recruiting

Study Design

Allocation randomized
Endpoint classification safety/efficacy study
Intervention model parallel assignment
Masking open label
Primary purpose treatment
Arm
(Active Comparator)
co.don chondrosphere® are spheroids in suspension, developed from autologous chondrocytes. The dose in group A is 3-7 spheroids/cm2 defect
co.don chondrosphere® ACT3D-CS
co.don chondrosphere® are spheroids in suspension, developed from autologous chondrocytes. The dose in group A is 3-7 spheroids/cm2 defect, in group B 10-30 spheroids/cm2 defect and in group C 40-70 spheroids/cm2 defect
(Active Comparator)
co.don chondrosphere® are spheroids in suspension, developed from autologous chondrocytes. The dose in group B is 10-30 spheroids/cm2 defect
co.don chondrosphere® ACT3D-CS
co.don chondrosphere® are spheroids in suspension, developed from autologous chondrocytes. The dose in group A is 3-7 spheroids/cm2 defect, in group B 10-30 spheroids/cm2 defect and in group C 40-70 spheroids/cm2 defect
(Active Comparator)
co.don chondrosphere® are spheroids in suspension, developed from autologous chondrocytes. The dose in group C is 40-70 Spheroids/cm2 defect
co.don chondrosphere® ACT3D-CS
co.don chondrosphere® are spheroids in suspension, developed from autologous chondrocytes. The dose in group A is 3-7 spheroids/cm2 defect, in group B 10-30 spheroids/cm2 defect and in group C 40-70 spheroids/cm2 defect

Primary Outcomes

Measure
Change of overall KOOS
time frame: 12 months after transplantation

Secondary Outcomes

Measure
Change of overall KOOS
time frame: 24, 36, 48, 60 months after transplantation
Change of the 5 subscores of the KOOS
time frame: 12, 24, 36 ,48, 60 months after transplantation
Assessment of MRIs by the MOCART-Score (MRI Score)
time frame: 12, 24, 36, 48 and 60 months after transplantation
Assessment of cartilage repair using an Arthroscopy and take a biopsy
time frame: 12 months after transplantation
Assessment of the histology from the biopsy by ICRS Visual Histological Assessment Score
time frame: 12 months after transplantation
Assessment of the histology from the biopsy by the Bern Score and additional histological scores
time frame: 12 months after transplantation
Change of ICRS/IKDC
time frame: 12, 24, 36, 48 and 60 months after transplantation
Assessment of change of modified Lysholm Score
time frame: 12, 24, 36, 48 and 60 months after transplantation
Days of absence from work (employment) and/or days of inability to follow usual activities
time frame: annual
Frequency and type of adverse events
time frame: 3,12, 24, 36, 48, 60 months after transplantation
Measurement of blood pressure, pulse and laboratory parameters
time frame: 3, 6, 12, 24, 36, 48, 60 months after transplantation

Eligibility Criteria

Male or female participants from 18 years up to 50 years old.

Inclusion Criteria: 1. Male or female patients, age: between 18 and 50 years 2. Defect: isolated ICRS grade III or IV single defect on medial or lateral femoral condyle, trochlea, tibia and retropatellar defects, also OCD (in case of OCD: Bone grafting up to the level of the original bone lamella must be performed if bone loss exceeds 3 mm in depth) 3. Defect size: ≥ 4 to 10 cm2 after debridement to healthy cartilage; chondral lesions, including osteochondritis dissecans on femoral condyle, trochlea, tibia,retropatellar defects up to 6 mm in depth. Assessment with MRI at Screening and per estimation during arthroscopy prior to randomization 4. Nearly intact surrounding chondral structure around the defect as well as corresponding joint area 5. Informed consent signed by patient 6. Patient understands strict rehabilitation protocol and follow-up programme and is willing to follow it. 7. In case of pain, patient agrees to use only paracetamol mono- (max 4 g/day) or combination preparation and oral and/or topic NSAIDs during the trial and to discontinue the use of oral and/or topic NSAIDs and/or paracetamol combination preparation 1 week before each visit whereas the use of paracetamol mono-preparation (max 4 g/day) is allowed. However, in the morning of the visit day, no pain medication is allowed. However, in the morning of the visit day, no pain medication is allowed. Other pain medications are allowed during surgical operation and may be taken for a period not exceeding 4 weeks after surgery. Exclusion Criteria: 1. Defects on both knees at the same time 2. Radiological signs of osteoarthritis 3. Any signs of knee instability 4. Valgus or varus malalignment (more than 5° over the mechanical axis) 5. Clinically relevant second cartilage lesion on the same knee 6. More than 50 % resection of a meniscus in the affected knee or incomplete meniscal rim 7. Rheumatoid arthritis, parainfectious or infectious arthritis, and condition after these diseases 8. Pregnancy and planned pregnancy (no MRI possible) 9. Obesity (Body Mass Index >30) 10. Uncontrolled diabetes mellitus 11. Serious illness 12. Poor general health as judged by physician 13. Participation in concurrent clinical trials or previous trials within 3 months of screening 14. Previous treatment with ACT in the affected knee 15. Microfracture performed less than 1 year before screening in the affected knee 16. Alcohol or drug (medication) abuse 17. Meniscal transplant in the affected knee 18. Meniscal suture (in the affected knee) three months prior to baseline 19. Mosaicplasty (Osteoarticular Transplant System, OATS) in the affected knee 20. Having received hyaluronic acid intra-articular injections in the affected knee within the last 3 months of baseline 21. Taking specific osteoarthritis drugs such as chondroitin sulfate, diacerein, n-glucosamine, piascledine, capsaicin within 2 weeks of baseline 22. Corticosteroid treatment by systemic or intra-articular route within the last month of baseline or intramuscular or oral corticosteroids within the last 2 weeks of baseline 23. Chronic use of anticoagulants 24. Any concomitant painful or disabling disease of the spine, hips or lower limbs that would interfere with evaluation of the afflicted knee 25. Any clinically significant or symptomatic vascular or neurological disorder of the lower extremities 26. Any evidence of the following diseases in the affected knee: septic arthritis,inflammatory joint disease, recurrent episodes of pseudogout, Paget's disease of bone, ochronosis, acromegaly, haemochromatosis, Wilson's disease, primary osteochondromatosis, heritable disorders, collagen gene mutation 27. Current diagnosis of osteomyelitis, human immunodeficiency virus (HIV-1, 2) and/or hepatitis C (HCV) infection

Additional Information

Official title Prospective, Randomised, Open Label, Multicentre Phase II Clinical Trial to Investigate the Efficacy and Safety of the Treatment of Large Cartilage Knee Defects(4-10 cm²) With 3 Diff. Doses of the ACT Product co.Don Chondrosphere®
Principal investigator Stefan Fickert, Ph.D.
Description see above
Trial information was received from ClinicalTrials.gov and was last updated in July 2014.
Information provided to ClinicalTrials.gov by co.don AG.