Osteoarthritis, KneeROSANCT04045431
Treatment of Knee Osteoarthritis With PAAG-OA
A study testing PAAG-OA and Synvisc-One in people with Osteoarthritis, Knee, run by Contura at 3 sites in Denmark.
Trial summary
This is a multi-center, randomized, double-blind clinical investigation to compare the effectiveness of intra-articular polyacrylamide hydrogel (PAAG-OA) and a hyaluronic acid, Synvisc-One to induce symptomatic benefit in subjects with knee osteoarthritis. Read more about this study
- Who is it for?
- Ages 40 years and older
- Conditions the study is for
- Osteoarthritis, Knee
- What is being tested?
- PAAG-OA and Synvisc-One
- Type of treatment
- Injection or infusion, Medical device
- Could I receive a placebo?
- No, everyone receives an active treatment
- How many people
- 238 participants
- Where
- 3 sitesDenmark
- Study dates
- 15 May 2019to 10 Mar 2025
- Phase
- Interventional
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 40 years and older
- All sexes
- No healthy volunteers
- Adult, Older adult
Who may be able to join
- Signed and dated informed consent form
- Stated willingness to comply with all study procedures and availability for the duration of the study
- Male or female, aged ≥ 40 years
- Clinical diagnosis of knee OA American College of Rheumatology criteria confirmed by radiology
- Definite radiographic OA in the most symptomatic knee (target knee) at mild to moderate-stage (Kellgren-Lawrence grades 2 or 3)
- Stable dose of analgesics for the past four weeks
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- NRS (11 points (0-10) pain intensity numerical rating scale) ≥ 4 in target knee, during the past week when walking
- Body Mass Index (BMI) between 20-35
- For females of reproductive potential: use of adequate contraception must be used throughout the trial
Who cannot join
- Female participants who are pregnant, lactating or planning pregnancy during the course of the clinical investigation
- Contraindications to PAAG-OA or Synvisc-One®, according to IB or Instruction for Use (IFU)
- Previous intra-articular injection of polyacrylamide gel in the target knee
- Previous intra-articular injection with hyaluronic acid or derivatives in target knee in the previous 6 months
- Significant valgus/varus deformity of the knee, ligamentous laxity or meniscal instability
- Other diseases in target knee than osteoarthritis
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- Intra-articular injection of any substance other than hyaluronic acid (e.g. corticosteroids) in the target knee within the last 3 months
- Acute serious infection of any region that required hospital care or intravenous antibiotic treatment within the last 30 days, or oral antibiotic treatment within the last 14 days
- Skin disease or infections in the area of the injection site
- Infected or severely inflamed knees
- History of sepsis in any joint or any clinical concern for a subacute infectious process in the target knee
- History of surgery in the target knee within the past 6 months
- Symptomatic osteoarthritis of the hips, spine or ankle, that interferes with the evaluation of the target knee
- Planned surgery on any lower extremity
- Clinically significant venous or lymphatic stasis present in the legs
- Clinically apparent tense effusion or inflammation in the target knee
- Suffering from any unstable or severe cardio-vascular disease
- Any contraindication to intra-articular e.g. anticoagulant therapy or clinical concern for potential coagulopathy (e.g. liver disease)
- Any foreign material in the target joint
- Any significant medical condition (e.g. significant psychiatric or neurological disorders or active alcohol/drug abuse), any medical condition that is unstable/poorly controlled or other factors that may interfere with study participation
- Treatment with systemic steroids
- History of drug/alcohol abuse, mental dysfunction of other factors limiting their ability to cooperate fully
- Change in physiotherapy within the previous month
- Fibromyalgia
- Inflammatory or other disease/condition which may affect joints (e.g. rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis among others)
- Haemophilia
- Any other condition that in the opinion of the investigator put a potential participant at risk or otherwise precludes participation in the trial
- Known allergic reactions to components of Synvisc-One (avian protein)
- Known allergic reactions to antibiotics (azithromycin and moxifloxacin) or local anaesthesia
- Participation in any experimental device study within 6 months prior to enrolment, or participation in an experimental drug study within 1 month prior to enrolment
Trial locations and contacts
3 sites in 1 country.
Denmark3 sites
The Parker Institute
Frederiksberg
A2 Reumatologi og idrætsmedicin
Hillerød
Reumatolog i Odense
Odense
About this study
Official title: A Multi-centre Randomized, Controlled, Double-blind Clinical Investigation of Intra-articular Polyacrylamide Hydrogel in Subjects With Knee Osteoarthritis Followed by an Open Label Extension Study
This is a multi-center, randomized, double-blind clinical investigation to compare the effectiveness of intra-articular polyacrylamide hydrogel (PAAG-OA) and a hyaluronic acid, Synvisc-One to induce symptomatic benefit in subjects with knee osteoarthritis.
Read the detailed description
The trial is designed as a multi-center, randomised, controlled, double-blind, and parallel-group trial spanning over 12 months with outcome assessments at baseline, 1, 3, 6 and 12 months incl. follow-up period between 2-5 years. Primary endpoint at 6 months. The trial is designed to compare effectiveness and safety of injection of PAAG-OA and Synvisc-One® in participants with knee OA.
- Conditions
- Osteoarthritis, Knee
- Being tested
- PAAG-OA, Synvisc-One
- Medical subject headings
- Osteoarthritis, Knee
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
PAAG-OADevice
Intra-articular injection of 6ml PAAG-OA in the target knee (incl. five (5) years follow-up) period.
Synvisc-OneDevice
Intra-articular injection of 6ml Synvisc-One in the target knee
| Study group | Role | What they receive |
|---|---|---|
| PAAG-OA | Experimental | Intra-articular injection with PAAG-OA (polyacrylamide hydrogel) Receives: Device: PAAG-OA |
| Synvisc-One | Active comparator | Intra-articular injection with Synvisc-One (hyaluronic acid) Receives: Device: Synvisc-One |
What is being measured
The primary outcome is the main question the study is designed to answer.
Comparing one injection of PAAG-OA with one injection of Synvisc-One on pain over 6 months in subjects with knee osteoarthritis
Change in WOMAC (WOMAC Osteoarthritis Index) pain subscale. Pain is reported in each of five response categories (0=none, 4=extreme)
Measured: 6 months
Secondary outcomes (4)
WOMAC
WOMAC (WOMAC Osteoarthritis Index) self reported pain, stiffness and physical function, categories (0=none, 4=extreme)
Measured: 1, 3, 6 and 12 months
PGA (Patient Global Assessment)
PGA reported on a 10 cm Visual Analogue Scale
Measured: 1, 3, 6 and 12 months
EQ-5D-5L, QoL
EQ-5D-5L, Quality of Life, comprised of descriptive system where each dimension has 5 levels (ranging from no problems to extreme problems) and a 20 cm Visual Analogue Scale (0 = worst health and 100 = best health)
Measured: 1, 3, 6 and 12 months
OMERACT-OARSI responder criteria
Per the OMERACT-OARSI criteria, a subject is classified as a positive responder if at least one (1) of the following two (2) conditions is observed at the post-baseline assessment:
- In either pain (WOMAC pain subscale) or function (WOMAC function subscale), a high improvement in the subscale, where high improvement in a subscale is achieved if there is both a > 50% improvement from Baseline and an absolute change from Baseline of > 20 normalised units (0-100 scale) OR
- Improvement in at least two (2) of the following three (3):
- Improvement in pain (WOMAC pain subscale) defined as > 20% improvement from Baseline and an absolute change from Baseline of > 10 (0-100 scale)
- Improvement in function (WOMAC function subscale) defined as > 20% improvement from Baseline and an absolute change from Baseline of > 10 (0-100 scale)
- Improvement in PGA defined as > 20% improvement from Baseline and an absolute change from Baseline of > 10 mm (0-100 sc
Measured: 1, 3, 6 and 12 months
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted5 Aug 2019
- Study start15 May 2019
- Primary completion1 Oct 2020
- Study completion10 Mar 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (2)Papers the sponsor has linked to this study.
- Other trials for Osteoarthritis, KneeStudies of the same condition, open and under way.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Interventional
- Phase
- Phase N/A
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind
- Who is masked
- Participant, Investigator
- Enrolment
- 238 participants (actual)
Sponsor and investigators
- Lead sponsor
- Contura
- Sponsor type
- Industry (pharma, biotech, devices)
- Responsible party
- Sponsor
- Investigators
- Henning Bliddal, MD, Principal investigator, The Parker Institute
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT04045431
- Sponsor's protocol ID
- CON-OA-001
- Acronym
- ROSA
- Status last verified
- Sep 2026
- First submitted
- 8 Jul 2019
- Last updated
- 16 Sep 2026
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
Publications
Bliddal H, Beier J, Hartkopp A, Conaghan PG, Henriksen M. Sustained symptom relief and safety over five years following a single intra-articular injection of 2.5[%] polyacrylamide hydrogel in patients with knee osteoarthritis. Clin Exp Rheumatol. 2026 Jul;44(7):1410-1417. doi: 10.55563/clinexprheumatol/bsper8. Epub 2026 Mar 4.
PubMed 41779591Bliddal H, Beier J, Hartkopp A, Conaghan PG, Henriksen M. Three-year follow-up from a randomised controlled trial of a single intra-articular polyacrylamide hydrogel injection in subjects with knee osteoarthritis. Clin Exp Rheumatol. 2026 May;44(5):996-1003. doi: 10.55563/clinexprheumatol/5lofry. Epub 2025 Dec 11.
PubMed 41487107
Study at a glance
From the registry record, last updated by the sponsor on 16 Sep 2026. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- A Multi-centre Randomized, Controlled, Double-blind Clinical Investigation of Intra-articular Polyacrylamide Hydrogel in Subjects With Knee Osteoarthritis Followed by an Open Label Extension Study
- ClinicalTrials.gov ID
- NCT04045431
- Acronym / sponsor ID
- ROSA / CON-OA-001
- Conditions
- Osteoarthritis, Knee
- Study type
- Interventional
- Recruitment status
- Completed
- Enrolment
- 238 participants (actual)
- Lead sponsor
- ConturaIndustry (pharma, biotech, devices)
- Study start
- 15 May 2019 (actual)
- Primary completion
- 1 Oct 2020 (actual)
- Study completion
- 10 Mar 2025 (actual)
- First posted
- 5 Aug 2019 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
This is a multi-center, randomized, double-blind clinical investigation to compare the effectiveness of intra-articular polyacrylamide hydrogel (PAAG-OA) and a hyaluronic acid, Synvisc-One to induce symptomatic benefit in subjects with knee osteoarthritis.
Detailed description
The trial is designed as a multi-center, randomised, controlled, double-blind, and parallel-group trial spanning over 12 months with outcome assessments at baseline, 1, 3, 6 and 12 months incl. follow-up period between 2-5 years. Primary endpoint at 6 months. The trial is designed to compare effectiveness and safety of injection of PAAG-OA and Synvisc-One® in participants with knee OA.
Study design
- Primary purpose
- Treatment
- Allocation
- Randomised
- Intervention model
- Parallel groups
- Masking
- Double blind (participant, investigator)
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| PAAG-OA | Experimental | Device: PAAG-OAIntra-articular injection with PAAG-OA (polyacrylamide hydrogel) |
| Synvisc-One | Active comparator | Device: Synvisc-OneIntra-articular injection with Synvisc-One (hyaluronic acid) |
Who may qualify
- Ages
- 40 years and older
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
Key inclusion criteria (9 listed)
- Signed and dated informed consent form
- Stated willingness to comply with all study procedures and availability for the duration of the study
- Male or female, aged ≥ 40 years
- Clinical diagnosis of knee OA American College of Rheumatology criteria confirmed by radiology
- Definite radiographic OA in the most symptomatic knee (target knee) at mild to moderate-stage (Kellgren-Lawrence grades 2 or 3)
Key exclusion criteria (30 listed)
- Female participants who are pregnant, lactating or planning pregnancy during the course of the clinical investigation
- Contraindications to PAAG-OA or Synvisc-One®, according to IB or Instruction for Use (IFU)
- Previous intra-articular injection of polyacrylamide gel in the target knee
- Previous intra-articular injection with hyaluronic acid or derivatives in target knee in the previous 6 months
- Significant valgus/varus deformity of the knee, ligamentous laxity or meniscal instability
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| PAAG-OAIntra-articular injection of 6ml PAAG-OA in the target knee (incl. five (5) years follow-up) period. | Device | PAAG-OA |
| Synvisc-OneIntra-articular injection of 6ml Synvisc-One in the target knee | Device | Synvisc-One |
Primary outcome
Comparing one injection of PAAG-OA with one injection of Synvisc-One on pain over 6 months in subjects with knee osteoarthritis
Time frame: 6 months
Change in WOMAC (WOMAC Osteoarthritis Index) pain subscale. Pain is reported in each of five response categories (0=none, 4=extreme)
4 secondary outcomes
WOMAC
Time frame: 1, 3, 6 and 12 months
PGA (Patient Global Assessment)
Time frame: 1, 3, 6 and 12 months
EQ-5D-5L, QoL
Time frame: 1, 3, 6 and 12 months
OMERACT-OARSI responder criteria
Time frame: 1, 3, 6 and 12 months
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 16 Sep 2026.
- Derived from this study: PubMed 41779591Bliddal H, Beier J, Hartkopp A, Conaghan PG, Henriksen M. Sustained symptom relief and safety over five years following a single intra-articular injection of 2.5[%] polyacrylamide hydrogel in patients with knee osteoarthritis. Clin Exp Rheumatol. 2026 Jul;44(7):1410-1417. doi: 10.55563/clinexprheumatol/bsper8. Epub 2026 Mar 4.
- Derived from this study: PubMed 41487107Bliddal H, Beier J, Hartkopp A, Conaghan PG, Henriksen M. Three-year follow-up from a randomised controlled trial of a single intra-articular polyacrylamide hydrogel injection in subjects with knee osteoarthritis. Clin Exp Rheumatol. 2026 May;44(5):996-1003. doi: 10.55563/clinexprheumatol/5lofry. Epub 2025 Dec 11.
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
Henning Bliddal, MD principal investigator
The Parker Institute
3 sites in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
A study testing PAAG-OA and Synvisc-One in people with Osteoarthritis, Knee, run by Contura at 3 sites in Denmark.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 9 inclusion and 30 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 16 Sep 2026. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 3 sites in Denmark. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Comparing one injection of PAAG-OA with one injection of Synvisc-One on pain over 6 months in subjects with knee osteoarthritis (time frame: 6 months). It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT04045431, which also lists 2 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 16 Sep 2026.