Trial Outcomes & Findings for A Study Evaluating Pain Relief and Safety of Orally Administered CR845 in Patients With Osteoarthritis of Hip or Knee (NCT NCT02944448)

NCT ID: NCT02944448

Last Updated: 2020-10-20

Results Overview

11-point NRS scale where 0 = no pain, and 10= pain as bad as you can imagine

Recruitment status

COMPLETED

Study phase

PHASE2

Target enrollment

761 participants

Primary outcome timeframe

Baseline, Week 8

Results posted on

2020-10-20

Participant Flow

Participant milestones

Participant milestones
Measure
CR845 Tablet
Every patient was started on a twice daily (BID) 1 mg dose of CR845. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
Twice daily dosing (BID)
Overall Study
STARTED
316
160
Overall Study
COMPLETED
227
136
Overall Study
NOT COMPLETED
89
24

Reasons for withdrawal

Reasons for withdrawal
Measure
CR845 Tablet
Every patient was started on a twice daily (BID) 1 mg dose of CR845. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
Twice daily dosing (BID)
Overall Study
Adverse Event
37
6
Overall Study
Lack of Efficacy
8
5
Overall Study
Lost to Follow-up
3
1
Overall Study
Protocol Violation
25
7
Overall Study
Withdrawal by Subject
14
4
Overall Study
Sponsor did not supply drug in time
0
1
Overall Study
Noncompliant with dosing
1
0
Overall Study
Abnormal laboratory values
1
0

Baseline Characteristics

A Study Evaluating Pain Relief and Safety of Orally Administered CR845 in Patients With Osteoarthritis of Hip or Knee

Baseline characteristics by cohort

Baseline characteristics by cohort
Measure
CR845 Tablet
n=316 Participants
Every patient was started on a twice daily (BID) 1 mg dose of CR845. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=160 Participants
Twice daily dosing (BID)
Total
n=476 Participants
Total of all reporting groups
Age, Continuous
60.4 years
STANDARD_DEVIATION 10.26 • n=93 Participants
60.8 years
STANDARD_DEVIATION 10.26 • n=4 Participants
60.5 years
STANDARD_DEVIATION 10.25 • n=27 Participants
Sex: Female, Male
Female
210 Participants
n=93 Participants
89 Participants
n=4 Participants
299 Participants
n=27 Participants
Sex: Female, Male
Male
106 Participants
n=93 Participants
71 Participants
n=4 Participants
177 Participants
n=27 Participants
Race (NIH/OMB)
American Indian or Alaska Native
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Asian
5 Participants
n=93 Participants
2 Participants
n=4 Participants
7 Participants
n=27 Participants
Race (NIH/OMB)
Native Hawaiian or Other Pacific Islander
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Black or African American
61 Participants
n=93 Participants
33 Participants
n=4 Participants
94 Participants
n=27 Participants
Race (NIH/OMB)
White
245 Participants
n=93 Participants
122 Participants
n=4 Participants
367 Participants
n=27 Participants
Race (NIH/OMB)
More than one race
0 Participants
n=93 Participants
0 Participants
n=4 Participants
0 Participants
n=27 Participants
Race (NIH/OMB)
Unknown or Not Reported
5 Participants
n=93 Participants
3 Participants
n=4 Participants
8 Participants
n=27 Participants

PRIMARY outcome

Timeframe: Baseline, Week 8

11-point NRS scale where 0 = no pain, and 10= pain as bad as you can imagine

Outcome measures

Outcome measures
Measure
CR845 Tablet
n=316 Participants
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=160 Participants
Twice daily dosing (BID)
Change From Baseline at Week 8 With Respect to the Weekly Mean of the Daily 24-hour Pain Intensity for the Index Joint as Measured by the Numeric Rating Scale (NRS).
-2.3 score on a scale
Standard Error 0.14
-2.4 score on a scale
Standard Error 0.19

SECONDARY outcome

Timeframe: Baseline, Week 8

The WOMAC Index is a self-administered assessment used to measure pain, stiffness, and physical function in patients with osteoarthritis. The WOMAC Index contains 24 questions across 3 different sub-scales (pain, stiffness, and function) all with scoring 0-10 (0 = No Pain/Stiffness/Difficulty, 10 = Extreme Pain/Stiffness/Difficulty). Each WOMAC Index Subscale score (Pain/Stiffness/Function) is calculated as the sum of all scores within that subscale. The pain subscale consists of five scores from 0-10, 0 is no pain 10 is extreme pain possible for a range of 0 - 50 points. The stiffness subscale consists of two scores from 0-10, 0 is no stiffness 10 is extreme stiffness possible for a range of 0 - 20 points. The function subscale consists of 17 scores from 0-10, 0 is no difficulty and 10 is extreme difficulty, for a range of 0 - 170 points. The WOMAC Index Total Score is calculated as the sum of all 24 scores (range of 0-240).

Outcome measures

Outcome measures
Measure
CR845 Tablet
n=223 Participants
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=133 Participants
Twice daily dosing (BID)
Change From Baseline in the Western Ontario & McMaster Osteoarthritis (WOMAC) Index Total Score at Week 8
-62.4 score on a scale
Standard Error 3.28
-59.7 score on a scale
Standard Error 4.34

SECONDARY outcome

Timeframe: Baseline, Week 8

The pain subscale consists of five scores from 0-10, 0 is no pain 10 is extreme pain possible for a range of 0 - 50 points.

Outcome measures

Outcome measures
Measure
CR845 Tablet
n=223 Participants
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=133 Participants
Twice daily dosing (BID)
Change From Baseline in the WOMAC Pain Intensity Sub-scale Score at Week 8
-13.5 score on a scale
Standard Error 0.70
-12.7 score on a scale
Standard Error 0.92

SECONDARY outcome

Timeframe: Baseline, Week 8

The stiffness subscale consists of two scores from 0-10, 0 is no stiffness 10 is extreme stiffness possible for a range of 0 - 20 points.

Outcome measures

Outcome measures
Measure
CR845 Tablet
n=223 Participants
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=133 Participants
Twice daily dosing (BID)
Change From Baseline in the WOMAC Stiffness Sub-scale Score at Week 8
-5.7 score on a scale
Standard Error 0.29
-5.6 score on a scale
Standard Error 0.38

SECONDARY outcome

Timeframe: Baseline, Week 8

The function subscale consists of 17 scores from 0-10, 0 is no difficulty and 10 is extreme difficulty, for a range of 0 - 170 points.

Outcome measures

Outcome measures
Measure
CR845 Tablet
n=223 Participants
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=133 Participants
Twice daily dosing (BID)
Change From Baseline in the WOMAC Function Sub-scale Score at Week 8
-43.1 score on a scale
Standard Error 2.34
-41.5 score on a scale
Standard Error 3.10

SECONDARY outcome

Timeframe: Week 8

A patient's pain response to treatment is defined as the percent improvement from baseline with respect to the weekly mean of "average pain in the last 24 hours" pain score during the last week of the Maintenance Treatment Period (Week 8) . If a patient's mean weekly pain score during the last week of the Maintenance Treatment Period is greater than the baseline score (i.e., the patient has an increase in pain compared to baseline), his/her response to treatment will be assigned a value of 0 (i.e. the patient will be considered a non-responder). Patients who discontinue study drug early will be considered non-responders to treatment and will be assigned a pain response of 0. The percentage of subjects achieving levels of treatment response 10% to 100% by 10% increments as defined above will be calculated with 30% of key interest as it has been shown to represent a clinically important improvement in pain.

Outcome measures

Outcome measures
Measure
CR845 Tablet
n=316 Participants
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=160 Participants
Twice daily dosing (BID)
Proportion of Patients With at Least 30% Improvement From Baseline in the Weekly Mean Pain Intensity at Week 8
41.5 percentage of patients
50.6 percentage of patients

SECONDARY outcome

Timeframe: Week 8

A patient's pain response to treatment is defined as the percent improvement from baseline with respect to the weekly mean of "average pain in the last 24 hours" pain score during the last week of the Maintenance Treatment Period (Week 8) . If a patient's mean weekly pain score during the last week of the Maintenance Treatment Period is greater than the baseline score (i.e., the patient has an increase in pain compared to baseline), his/her response to treatment will be assigned a value of 0 (i.e. the patient will be considered a non-responder). Patients who discontinue study drug early will be considered non-responders to treatment and will be assigned a pain response of 0. The percentage of subjects achieving levels of treatment response 10% to 100% by 10% increments as defined above will be calculated with 30% of key interest as it has been shown to represent a clinically important improvement in pain.

Outcome measures

Outcome measures
Measure
CR845 Tablet
n=316 Participants
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=160 Participants
Twice daily dosing (BID)
Proportion of Patients With at Least 50% Improvement From Baseline in the Weekly Mean Pain Intensity at Week 8
25.6 percentage of patients
31.3 percentage of patients

SECONDARY outcome

Timeframe: Week 8

The PGIC is a self-administered instrument that measures the patient's overall impression of his/her OA on a 7-point scale where 1 = "Very much improved" and 7 = "Very much worse".

Outcome measures

Outcome measures
Measure
CR845 Tablet
n=316 Participants
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=160 Participants
Twice daily dosing (BID)
Proportion of Patients Whose OA Pain Was "Very Much Improved" or "Much Improved" as Indicated by Patient Global Impression of Change (PGIC) Score at Week 8
44.3 percentage of patients
40.0 percentage of patients

SECONDARY outcome

Timeframe: Week 8

The average daily number of acetaminophen tablets used during the study will be calculated using data recorded in the patient diary as the sum of the total number of tablets used divided by the length of exposure (in days). The supplemental pain medication for OA will be grouped categorically into the following classes: (1) no supplemental acetaminophen tablets, (2) 0 to ≤ 0.5 tablets, (3) \> 0.5 to ≤ 1.0 tablets, (4) \> 1.0 to ≤ 2.0 tablets, and (5) \> 2.0 tablets.

Outcome measures

Outcome measures
Measure
CR845 Tablet
n=316 Participants
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=160 Participants
Twice daily dosing (BID)
Average Daily Number of Acetaminophen Tablets Used During Entire Study
0.5 Tablets
Standard Deviation 2.27
0.4 Tablets
Standard Deviation 1.75

SECONDARY outcome

Timeframe: Week 8

Outcome measures

Outcome measures
Measure
CR845 Tablet
n=316 Participants
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=160 Participants
Twice daily dosing (BID)
Proportion of Patients Withdrawing From Treatment Due to Lack of Analgesic Efficacy
2.5 percentage of patients
3.1 percentage of patients

Adverse Events

CR845 Tablet

Serious events: 9 serious events
Other events: 82 other events
Deaths: 0 deaths

Placebo Tablet

Serious events: 1 serious events
Other events: 17 other events
Deaths: 0 deaths

Serious adverse events

Serious adverse events
Measure
CR845 Tablet
n=316 participants at risk
Every patient was started on a twice daily (BID) 1 mg dose of CR845. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=160 participants at risk
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. Placebo tablet: Placebo tablets will be provided as enteric-coated tablets. All tablets are white in color with no markings and are identical in appearance, regardless of dose and treatment.
Gastrointestinal disorders
Gastrooesophageal reflux disease
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Gastrointestinal disorders
Small intestinal obstruction
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Hepatobiliary disorders
Cholecystitis
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Infections and infestations
Pneumonia
0.00%
0/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.62%
1/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Injury, poisoning and procedural complications
Alcohol poisoning
0.00%
0/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.62%
1/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Injury, poisoning and procedural complications
Head injury
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Injury, poisoning and procedural complications
Lumbar vertebral fracture
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Injury, poisoning and procedural complications
Rib fracture
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Injury, poisoning and procedural complications
Subdural haemorrhage
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Injury, poisoning and procedural complications
Thoracic vertebral fracture
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Musculoskeletal and connective tissue disorders
Arthritis
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Nervous system disorders
Encephalopathy
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Nervous system disorders
Metabolic encephalopathy
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Nervous system disorders
Subarachnoid haemorrhage
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Psychiatric disorders
Mental Status Changes
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Respiratory, thoracic and mediastinal disorders
Pleuritic pain
0.32%
1/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
0.00%
0/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.

Other adverse events

Other adverse events
Measure
CR845 Tablet
n=316 participants at risk
Every patient was started on a twice daily (BID) 1 mg dose of CR845. During the post-randomization Titration-to-Effect Period, the dose of study drug may have been increased to 2.5 mg BID or 5 mg BID in a double-blind fashion.
Placebo Tablet
n=160 participants at risk
Dosing twice a day (BID) for a total of 8 weeks, with each dose administered at least 2 hours prior to or after a meal. Placebo tablet: Placebo tablets will be provided as enteric-coated tablets. All tablets are white in color with no markings and are identical in appearance, regardless of dose and treatment.
Gastrointestinal disorders
Constipation
13.3%
42/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
1.9%
3/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Nervous system disorders
Dizziness
8.2%
26/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
1.9%
3/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Nervous system disorders
Headache
5.7%
18/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
5.6%
9/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
Gastrointestinal disorders
Dry mouth
5.7%
18/316 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.
1.9%
3/160 • 59 Days
Treatment emergent AEs (TEAEs) will be defined as AEs where onset occurs from the day of first dose of study medication up to and including the 2nd day following the day of last dose of study medication.

Additional Information

Frédérique Menzaghi, PhD

Cara Therapeutics

Phone: 203-406-3700

Results disclosure agreements

  • Principal investigator is a sponsor employee
  • Publication restrictions are in place