학술논문

A Phase 2b randomized trial of lorecivivint, a novel intra-articular CLK2/DYRK1A inhibitor and Wnt pathway modulator for knee osteoarthritis
Document Type
article
Source
Osteoarthritis and Cartilage. 29(5)
Subject
Clinical Trials and Supportive Activities
Aging
Pain Research
Clinical Research
Arthritis
Chronic Pain
6.1 Pharmaceuticals
Evaluation of treatments and therapeutic interventions
Musculoskeletal
Anti-Inflammatory Agents
Double-Blind Method
Female
Humans
Imidazoles
Indazoles
Injections
Intra-Articular
Male
Middle Aged
Osteoarthritis
Knee
Pain Measurement
Patient Reported Outcome Measures
Pyridines
Radiography
Clinical trial
Wnt pathway
Patient-reported outcomes
CLK2
DYRK1A
Knee pain
Biomedical Engineering
Clinical Sciences
Human Movement and Sports Sciences
Arthritis & Rheumatology
Language
Abstract
ObjectiveLorecivivint (LOR; SM04690), an investigational Wnt pathway modulator, previously demonstrated patient-reported and radiographic outcome improvements vs placebo in clinically relevant subjects with moderate to severe knee osteoarthritis (OA). This study's objective was to identify effective LOR doses.DesignSubjects in this 24-week, Phase 2b, multicenter, randomized, double-blind, placebo (PBO)-controlled trial received an intra-articular injection of 2 mL LOR (0.03, 0.07, 0.15, or 0.23 mg), PBO, or dry-needle sham. The primary efficacy endpoints were changes in Pain NRS [0-10], WOMAC Pain [0-100], WOMAC Function [0-100], and radiographic mJSW outcomes, which were measured using baseline-adjusted analysis of covariance at Week 24. Multiple Comparison Procedure-Modeling (MCP-Mod) was performed for dose modeling.ResultsIn total, 695/700 subjects were treated. Pain NRS showed significant improvements vs PBO after treatment with 0.07 mg and 0.23 mg LOR at Weeks 12 (-0.96, 95% CI [-1.54, -0.37], P = 0.001; -0.78 [-1.39, -0.17], P = 0.012) and 24 (-0.70 [-1.34, -0.06], P = 0.031; -0.82 [-1.51, -0.12], P = 0.022). Additionally, 0.07 mg LOR significantly improved WOMAC Pain and Function subscores vs PBO at Week 12 (P = 0.04, P = 0.021), and 0.23 mg LOR significantly improved both WOMAC subscores at Week 24 (P = 0.031, P = 0.017). No significant differences from PBO were observed for other doses. No radiographic progression was observed in any group at Week 24. MCP-Mod identified 0.07 mg LOR as the lowest effective dose.ConclusionThis 24-week Phase 2b trial demonstrated the efficacy of LOR on PROs in knee OA subjects. The optimal dose for future studies was identified as 0.07 mg LOR.