Safety and Feasibility of Umbilical Cord Wharton's Jelly Allograft Injections for Knee Osteoarthritis

NCT ID: NCT06608134

Last Updated: 2024-09-23

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

EARLY_PHASE1

Total Enrollment

120 participants

Study Classification

INTERVENTIONAL

Study Start Date

2024-10-01

Study Completion Date

2029-10-01

Brief Summary

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This is a Pilot Study which is randomized, prospective, open label, dose escalation, non-controlled evaluating safety and feasibility of intra-articular Wharton's Jelly (WJ) allograft will be evaluated in patients suffering with knee osteoarthritis. The participants will be randomized to one of three dosing treatment arms that will consist of one intra-articular knee injection containing either low dose, medium dose or high dose WJ allograft tissue.

Detailed Description

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This is a Pilot Study which is randomized, prospective, open label, dose escalation, non-controlled study in which the safety and feasibility of intra-articular Wharton's Jelly (WJ) allograft will be evaluated in patients suffering with knee OA. The participants will be randomized to one of three dosing treatment arms that will consist of one intra-articular knee injection containing either low dose, medium dose or high dose WJ allograft tissue.

As this is a Pilot Study primarily designed to evaluate safety, no control will be used. The dosing groups will consist of either 2cc WJ Allograft (Low Dose), 3cc WJ Allograft (Medium Dose), or 4cc WJ Allograft (High Dose) with 120 total patients randomized into the three arms equally. In addition to baseline outcome instruments along with imaging and laboratory studies, patients will be followed for one year for evaluation of safety, pain relief and functional improvements.

Conditions

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Osteoarthritis, Knee

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

randomized, prospective, open label, dose escalation, non-controlled
Primary Study Purpose

TREATMENT

Blinding Strategy

DOUBLE

Participants Caregivers
With double blinding of the allograft neither participant nor provider will know what is being administered.

Study Groups

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2cc WJ Allograft (Low Dose)

The 2cc Whartons Jelly Allograft group receives an intra-articular knee injection and is considered the Low Dose Group.

Group Type ACTIVE_COMPARATOR

Umbilical Cord Wharton's Jelly Allograft Intra-articular Knee Injection

Intervention Type BIOLOGICAL

Direct injection of biologic into the knee joint.

3cc WJ Allograft (Medium Dose)

The 3cc Whartons Jelly Allograft group receives an intra-articular knee injection and is considered the Medium Dose Group.

Group Type ACTIVE_COMPARATOR

Umbilical Cord Wharton's Jelly Allograft Intra-articular Knee Injection

Intervention Type BIOLOGICAL

Direct injection of biologic into the knee joint.

4cc WJ Allograft (High Dose)

The 4cc Whartons Jelly Allograft group receives an intra-articular knee injection and is considered the High Dose Group.

Group Type ACTIVE_COMPARATOR

Umbilical Cord Wharton's Jelly Allograft Intra-articular Knee Injection

Intervention Type BIOLOGICAL

Direct injection of biologic into the knee joint.

Interventions

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Umbilical Cord Wharton's Jelly Allograft Intra-articular Knee Injection

Direct injection of biologic into the knee joint.

Intervention Type BIOLOGICAL

Eligibility Criteria

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Inclusion Criteria

* Be over age 30
* Diagnosed with Grade II or III OA on the KL scale (in one knee).
* Body Mass Index (BMI) \<50Kg/m2
* Pain score of 4 or more on the Numeric Pain Rating Scale (NPRS)
* Female patients must be abstinent, surgically sterilized or postmenopausal
* Premenopausal females must have a negative pregnancy test, on contraceptive measures and do not anticipate pregnancy during the duration of the study.
* Be willing and capable of giving written informed consent to participate in English.
* Be willing and capable of complying with study-related requirements, procedures and visits in English.

Exclusion Criteria

* Have taken any pain medication including nonsteroidal anti-inflammatory drugs (NSAIDs) within 2 weeks prior to study injection date.
* Use anticoagulants have a substance abuse history and fail to agree not to take any knee-symptom modifying drugs during the course of the study without discussing and reporting the use to the site principal investigator and study team.
* Have had an intra-articular injection of any drug including viscosupplementation in the index knee in the past 6 months.
* Have had surgery on the index knee with the past 6 months.
* Had a traumatic injury to the index knee with the past 3 months.
* Planned elective surgery during the course of the study.
* A history of organ or hematologic transplantation, rheumatoid arthritis, or other autoimmune disorders.
* Be on immunosuppressive medications.
* Have a diagnosis of carcinoma with the past 2 years.
* Have a knee infection or have used antibiotics for knee infection within the past 3 months.
* Have participated in any other clinical trial or treatment (not just for the knee, but for any reason) with any investigational product within the past 30 days prior to inclusion of study.
* Female patients who are breast feeding or are pregnant or desire to become pregnant during the course of the study.
* Contraindications to radiographic or MRI imaging.
* Serious neurological, psychological or psychiatric disorders.
* Injury or disability claims under current litigation or pending or approved workers compensation claims.
* Have a known drug allergy to amphotericin-B, ciprofloxacin, gentamycin, penicillin, or streptomycin.
Minimum Eligible Age

30 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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R3 Medical Research

INDUSTRY

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Locations

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R3 Anti Aging Scottsdale

Scottsdale, Arizona, United States

Site Status RECRUITING

R3 Anti Aging Beverly Hills

Beverly Hills, California, United States

Site Status RECRUITING

Optimal Medical Group

Fresno, California, United States

Site Status RECRUITING

Scheer Medical Wellness

New York, New York, United States

Site Status RECRUITING

Dr. Duc (Steve) Le, MD

Cleveland, Texas, United States

Site Status RECRUITING

Countries

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United States

Facility Contacts

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Dr. Sabrina Solt, NMD

Role: primary

480-306-6256

Neville Campbell, MD

Role: primary

424-382-1074

Dr. Lucia Mireles-Chavez, MD

Role: primary

559-425-1118

Dr. Alexandre Scheer, MD

Role: primary

212-391-8080

Duc Le, MD

Role: primary

281-593-1500

References

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Farr J, Gomoll AH, Yanke AB, Strauss EJ, Mowry KC; ASA Study Group. A Randomized Controlled Single-Blind Study Demonstrating Superiority of Amniotic Suspension Allograft Injection Over Hyaluronic Acid and Saline Control for Modification of Knee Osteoarthritis Symptoms. J Knee Surg. 2019 Nov;32(11):1143-1154. doi: 10.1055/s-0039-1696672. Epub 2019 Sep 18.

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Hoorntje A, Witjes S, Koenraadt KLM, Aarts R, Weert T, van Geenen RCI. More Severe Preoperative Kellgren-Lawrence Grades of Knee Osteoarthritis were Partially Associated with Better Postoperative Patient-Reported Outcomes in TKA Patients. J Knee Surg. 2019 Mar;32(3):211-217. doi: 10.1055/s-0038-1635114. Epub 2018 Feb 28.

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Rodriguez HC, Gupta M, Cavazos-Escobar E, El-Amin SF 3rd, Gupta A. Umbilical cord: an allogenic tissue for potential treatment of COVID-19. Hum Cell. 2021 Jan;34(1):1-13. doi: 10.1007/s13577-020-00444-5. Epub 2020 Oct 9.

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PMID: 33033884 (View on PubMed)

Gupta A, Cady C, Fauser AM, Rodriguez HC, Mistovich RJ, Potty AGR, Maffulli N. Cell-free Stem Cell-Derived Extract Formulation for Regenerative Medicine Applications. Int J Mol Sci. 2020 Dec 9;21(24):9364. doi: 10.3390/ijms21249364.

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Main BJ, Maffulli N, Valk JA, Rodriguez HC, Gupta M, El-Amin SF 3rd, Gupta A. Umbilical Cord-Derived Wharton's Jelly for Regenerative Medicine Applications: A Systematic Review. Pharmaceuticals (Basel). 2021 Oct 27;14(11):1090. doi: 10.3390/ph14111090.

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PMID: 34832872 (View on PubMed)

Gupta A, El-Amin SF 3rd, Levy HJ, Sze-Tu R, Ibim SE, Maffulli N. Umbilical cord-derived Wharton's jelly for regenerative medicine applications. J Orthop Surg Res. 2020 Feb 13;15(1):49. doi: 10.1186/s13018-020-1553-7.

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Dernek B, Duymus TM, Koseoglu PK, Aydin T, Kesiktas FN, Aksoy C, Mutlu S. Efficacy of single-dose hyaluronic acid products with two different structures in patients with early-stage knee osteoarthritis. J Phys Ther Sci. 2016 Nov;28(11):3036-3040. doi: 10.1589/jpts.28.3036. Epub 2016 Nov 29.

Reference Type RESULT
PMID: 27942115 (View on PubMed)

Other Identifiers

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R3-WJI-001

Identifier Type: -

Identifier Source: org_study_id

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