PEP and Euflexxa for Osteoarthritis

MM
SK
Overseen ByShariq Khan, M.S.
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to test the safety and potential benefits of a new treatment for knee osteoarthritis. Participants will receive varying doses of a treatment called PEP, with some also receiving Euflexxa, a type of hyaluronic acid injection. The trial seeks individuals who have experienced knee osteoarthritis for at least six months and have not found relief with other treatments such as pain relievers, physical therapy, or injections. If daily knee pain persists despite these methods, this trial might be suitable. As a Phase 1 trial, the research focuses on understanding how the treatment works in people, offering participants the opportunity to be among the first to receive this new treatment.

Will I have to stop taking my current medications?

The trial protocol does not specify if you need to stop taking your current medications. However, if you have had steroid or viscosupplement injections in the last 3 months, or PRP injections in the last 6 months, you may not be eligible to participate.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Studies have shown that PEP, a type of platelet-rich plasma, is generally safe for treating knee osteoarthritis (OA). It has improved joint function and reduced pain in other studies, with patients tolerating it well and few reports of side effects.

Research on Euflexxa, a hyaluronic acid injection, suggests it is also safe for knee OA. One study found it was well-tolerated over 26 weeks, with only some patients experiencing joint swelling, which was uncommon.

Both PEP and Euflexxa have good safety records, making them promising options for those considering this clinical trial.12345

Why are researchers excited about this trial's treatments?

Researchers are excited about these treatments for osteoarthritis because they explore new combinations and dosages of PEP and Euflexxa, which could offer enhanced relief. Unlike standard treatments like NSAIDs or corticosteroid injections, PEP involves a unique mechanism by potentially targeting inflammation at a molecular level, while Euflexxa is a form of hyaluronic acid that lubricates joints. The combination of PEP and Euflexxa in different doses might provide more comprehensive symptom management, potentially improving both pain and joint function more effectively than current options.

What evidence suggests that this trial's treatments could be effective for knee osteoarthritis?

Research has shown that platelet-rich plasma (PRP), a key component of PEP, can improve knee osteoarthritis more effectively than hyaluronic acid alone. Studies have found that PRP is safe and helps reduce pain while improving knee movement. In this trial, some participants will receive PEP alone, while others will receive the PEP/Euflexxa combination. Combining PRP with hyaluronic acid, as in the PEP/Euflexxa treatment, may offer even greater benefits for those with moderate knee osteoarthritis. Patients have reported less pain and better knee function in both short- and mid-term assessments. These findings suggest that PEP and PEP/Euflexxa could be effective options for managing knee osteoarthritis.16789

Are You a Good Fit for This Trial?

This trial is for individuals with knee osteoarthritis. Participants should be adults who are experiencing symptoms and have not found relief from other treatments. Details on specific inclusion or exclusion criteria are not provided, but typically these would outline the severity of osteoarthritis, age range, overall health status, and any medications or conditions that might interfere with the trial.

Inclusion Criteria

I have had daily knee pain for over 6 months, scoring between 30 to 80 out of 100.
I am seeking injection therapy for pain relief.
Ability to comply with protocol
See 6 more

Exclusion Criteria

I have not had a knee cleaning surgery in the last 6 months.
Concurrent participation in another investigational drug or device study or participation in the last 30 days prior to enrollment
I do not have severe nerve, heart, lung, or rheumatic diseases affecting my daily activities.
See 16 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive a single intra-articular injection of PEP, with or without EUFLEXXA, at low or high doses

1 day
1 visit (in-person)

Primary Safety Follow-up

Participants are monitored for safety through the occurrence of DLTs for 90 days post-injection

90 days

Long Term Safety Follow-up

Participants are monitored for long-term safety from Day 91 to Day 365 post-injection

275 days

What Are the Treatments Tested in This Trial?

Interventions

  • PEP
  • PEP/Euflexxa
Trial Overview The study is testing single intra-articular injections (directly into the knee joint) of a product called PEP at two different doses: low (one vial) and high (two vials). It's also looking at PEP combined with EUFLEXXA to see if they're safe and potentially effective in treating knee osteoarthritis.
How Is the Trial Designed?
4Treatment groups
Experimental Treatment
Group I: 2b PEP-EUFLEXXA High DoseExperimental Treatment1 Intervention
Group II: 2a PEP-EUFLEXXA Low DoseExperimental Treatment1 Intervention
Group III: 1B PEP High DoseExperimental Treatment1 Intervention
Group IV: 1A PEP Low DoseExperimental Treatment1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

Rion Inc.

Lead Sponsor

Trials
4
Recruited
260+

Caidya Clinical Research Organization

Collaborator

Trials
1
Recruited
20+

Published Research Related to This Trial

Etanercept is effective in treating juvenile idiopathic arthritis (JIA) categories such as extended oligoarthritis, enthesitis-related arthritis, and psoriatic arthritis, showing significant improvement in disease activity scores over 3 to 24 months in a study of 1,678 patients.
While etanercept is generally safe, there is an increased risk of serious and non-serious adverse events, particularly uveitis flares and reports of chronic inflammatory bowel disease in patients with these JIA categories, indicating the need for careful monitoring.
Safety and efficacy of etanercept in children with the JIA categories extended oligoarthritis, enthesitis-related arthritis and psoriasis arthritis.Windschall, D., Müller, T., Becker, I., et al.[2021]
Celecoxib is associated with a slightly increased risk of certain adverse events, such as edema, hypertension, angioedema, and allergic reactions compared to placebo, but these risks are relatively small.
In contrast, celecoxib shows a lower risk of gastrointestinal issues like hemorrhage and ulceration compared to non-selective NSAIDs, suggesting it may be a safer option for patients concerned about GI side effects.
Safety of celecoxib compared with placebo and non-selective NSAIDs: cumulative meta-analysis of 89 randomized controlled trials.Essex, MN., Zhang, RY., Berger, MF., et al.[2022]

Citations

Comparative efficacy of intra-articular platelet-rich plasma ...NSAIDs showed minimal improvement. Radiographic progression was minimal in all the groups. No major adverse events were observed. PRP offered ...
Efficacy and safety of platelet-rich plasma injections for the ...Compared to corticosteroids, PRP showed no significant difference in efficacy as monotherapy but enhanced outcomes when used in combination. ...
Platelet Rich Plasma for Knee Osteoarthritis: When it works ...“Patients undergoing treatment for knee osteoarthritis with PRP can be expected to experience improved clinical outcomes when compared with hyaluronic acid.” A ...
Long-term effectiveness of intra-articular injectables in ...The study included 37 RCTs involving 5089 patients. The outcomes assessed were pain relief and functional improvement of knee joint. The random ...
Efficacy and safety of platelet-rich plasma injections for the ...PRP injection therapy can safely and effectively improve functional activity in patients with OA and produce positive analgesic effects in patients with KOA, ...
6.pubmed.ncbi.nlm.nih.govpubmed.ncbi.nlm.nih.gov/37441691/
Efficacy and safety of platelet-rich plasma injections for the ...Conclusion: PRP injection therapy can safely and effectively improve functional activity in patients with OA and produce positive analgesic ...
Effectiveness and safety of intra-articular interventions for ...Effectiveness and safety of intra-articular interventions for knee and hip osteoarthritis based on large randomized trials: A systematic review and network ...
Phase 1b Clinical Trial to Evaluate PEP and EUFLEXXA for ...The purpose of this study is to evaluate the safety and exploratory efficacy of single intra-articular injections of PEP reconstituted with 0.9% ...
Efficacy and safety of corticosteroids, hyaluronic acid, and ...The current study found that PRP and PRP + HA were the most successful in improving function and alleviating pain after 3, 6, and 12 months of follow-up.
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